A 24-year-old male had a headache, malaise, and low-grade fever for the past 4 days. He was brought to the emergency room this morning after he started behaving in an unusual manner and experienced difficulty in speaking. While he was being transported, he suffered a generalized seizure. Physical examination showed a fever of 103°F and total disorientation. Deep tendon reflexes were exaggerated and the plantar response was bilaterally extensor. He had mild neck stiffness and the optic fundi showed early papilledema. A lumbar puncture produced clear CSF under an opening pressure of 300 mm H2O. Protein was 160 mg/dL, glucose 66 mg/dL (blood glucose 90 mg/dL), and there were 32 mononuclear cells/μL. No PMNs were present. Which of the following is the most likely cause of this man’s condition?
herpetic meningoencephalitis
glioblastoma multiforme
meningioma
meningococcal meningitis
spontaneous cerebral hemorrhage
subarachnoid hemorrhage
27 мар 2024
