A 7-Year-Old Boy Is Brought to the Emergency Department Due

A 7-year-old boy is brought to the emergency department due to fever, headache, vomiting, and confusion.  He has no prior medical conditions and is up to date with immunizations.  The patient has not traveled recently, and his parents report no exposure to individuals with similar symptoms or ingestion of anything out of the ordinary.  They have recently noticed several dead birds around their neighborhood.  Temperature is 39 C (102.2 F) .  Physical examination shows neck rigidity and right lower extremity weakness with fasciculations.  Cerebrospinal fluid analysis shows a leukocyte count of 200/mm³ with 20% neutrophils and 80% lymphocytes.  Which of the following is the most likely pathogen responsible for this patient's condition?

A) Cryptococcus neoformans
B) Hemophilus influenzae
C) Herpes simplex virus
D) Nonpolio enterovirus
E) Polio virus
F) Streptococcus pneumoniae
G) West Nile virus

Correct Answer:

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