IDBR Infectious Disease Board Review

Latest Episodes:

A CNS Problem - Camille Kotton, MD / John Bennett, MD Apr 27, 2024

Show notes

A 31-year-old woman is brought to the emergency department by her husband for fever and neurological symptoms.

She was completely well until 3 days earlier, when she felt nauseated and vomited twice. During the next two days she had fever, felt “achy,” developed a headache, and continued to have nausea and vomiting. Upon awakening this morning, she complained of double vision, and her husband noted her eyes “weren’t looking in the same place.”

In the emergency room, she was found to have a temperature of 102.4ÅãF. There was no rash. She had mild nuchal rigidity, right 6th cranial nerve palsy, and a sensory deficit over most of the left side of her body. Her gait was very unsteady. The rest of the exam was unremarkable. An MRI of the head demonstrated inflammation of the pons and medulla.

Which one of the following organisms is the most likely cause of her illness?

A. Streptococcus pneumoniae

B. Nocardia nova

C. Mycobacterium tuberculosis

D. Listeria monocytogenes

E. Cryptococcus neoformans

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