A 30-Year-Old Man Is Brought to the Emergency Department Due

question 40

Multiple Choice

A 30-year-old man is brought to the emergency department due to erratic behavior, progressive right-sided weakness, and difficulty walking for the last month.  The patient was diagnosed with HIV several years ago and is not compliant with antiretroviral treatment.  Physical examination shows a cachectic and disheveled man.  Funduscopic examination shows no abnormalities.  Motor strength in the right upper and lower extremities is decreased, and his gait is ataxic.  Brain MRI reveals several discrete areas of demyelination in the subcortical and periventricular white matter with no surrounding edema or mass effect.  CD4 cell count is 30/mm³.  Reactivation of which of the following pathogens is most likely responsible for this patient's current symptoms?

• A)Cytomegalovirus
• B)Epstein-Barr virus
• C)Herpes simplex virus
• D)JC virus
• E)Measles virus
• F)Toxoplasma gondii

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