A 58-Year-Old Man Comes to the Emergency Department with a 1-Day

A 58-year-old man comes to the emergency department with a 1-day history of fever, headache, and vomiting.  He underwent kidney transplantation last year.  His temperature is 39.4 C (103 F) , blood pressure is 130/80 mm Hg, pulse is 98/min, and respirations are 16/min.  Neck stiffness is present on physical examination.  Cerebrospinal fluid (CSF) results are as follows: Gram-positive rods with tumbling motility at room temperature are seen on CSF microscopy.  How was this patient's infection most likely transmitted?

A) Arthropod bite
B) Contaminated food
C) Needlestick
D) Respiratory droplets
E) Unprotected sex

Correct Answer:

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