A 46-Year-Old Man Is Brought to the Emergency Department Due

question 575

Multiple Choice

A 46-year-old man is brought to the emergency department due to a generalized tonic-clonic seizure.  The patient has no chronic medical problems and, prior to today, had never had a seizure.  He does not use tobacco, alcohol, or illicit drugs.  The patient is a Christian missionary and recently spent 3 months with rural Bolivian pig farmers.  Temperature is 36.8 C (98.2 F) , blood pressure is 120/70 mm Hg, and pulse is 86/min.  The patient is drowsy and postictal.  Electroencephalogram shows epileptiform activity.  MRI of the brain demonstrates several intraparenchymal, 5- to 10-mm cystic lesions with surrounding edema.  There is no mass effect or midline shift.  A rapid HIV test is negative.  Which of the following is the most likely cause of this patient's current condition?

• A)Abnormal protein in an infected animal brain
• B)Infectious oocysts in feline feces
• C)Neurotropic virus acquired from an infected animal bite
• D)Parasite eggs in contaminated food or water
• E)Sporozoite inoculation from a mosquito bite
• F)Nasal mucosal penetration by fresh-water amoebas

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