A 24-Year-Old Man Is Brought to the Emergency Department Due

A 24-year-old man is brought to the emergency department due to seizures.  He has had 2 days of worsening fever, headache, and vomiting.  Physical examination shows signs of meningeal irritation.  The patient rapidly becomes comatose and dies 48 hours later despite aggressive medical care.  Autopsy examination shows congested leptomeninges with fibrinopurulent exudate (not shown) .  Microscopy reveals numerous ameba in the exudate and brain tissue.  Which of the following is the most likely portal of entry of this pathogen into the CNS?

A) A
B) B
C) C
D) D
E) E

Correct Answer:

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