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QUESTION 7


On physical exam, the patient has a fever to 39°C, but no rash or bites are noted. He reacted only to pain and not verbal stimuli.


Routine labs were normal, including FBC. MRI scan showed focal enhancement in the right medial temporal lobe.


Lumbar puncture: opening pressure normal; WBC: 400 cells (98% lymphocytes) with normal glucose, protein 110 mg/dL.

PCR of CSF for various pathogens is pending.

Which of the following viruses would be the most likely cause of this disease?


(1) Japanese encephalitis virus (JEV)

(2) St. Louis virus

(3) West Nile virus

(4) California virus

(5) Herpes simplex virus

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BOF 22 Jan 2016

By Wong Chen Seong