A 5-year-old boy is brought to the emergency department because of irritability and fever for 2 days. His symptoms began shortly after returning from a family trip to Canada. He was born at term. His immunizations are up-to-date. The boy appears weak and lethargic. He is at the 50th percentile for height and 75th percentile for weight. His temperature is 39.2°C (102.5°F), pulse is 110/min, respirations are 28/min, and blood pressure is 92/55 mm Hg. Examination shows mild pharyngeal erythema in addition to neck stiffness. Capillary refill time is 4 seconds. The remainder of the examination shows no abnormalities. His hemoglobin concentration is 12 g/dL, leukocyte count is 19,000/mm3, and platelet count is 225,000/mm3. A lumbar puncture is done; cerebrospinal fluid analysis shows Which of the following infectious agents is most likely to have caused this patient's illness?

Question

A 5-year-old boy is brought to the emergency department because of irritability and fever for 2 days. His symptoms began shortly after returning from a family trip to Canada. He was born at term. His immunizations are up-to-date. The boy appears weak and lethargic. He is at the 50th percentile for height and 75th percentile for weight. His temperature is 39.2°C (102.5°F), pulse is 110/min, respirations are 28/min, and blood pressure is 92/55 mm Hg. Examination shows mild pharyngeal erythema in addition to neck stiffness. Capillary refill time is 4 seconds. The remainder of the examination shows no abnormalities. His hemoglobin concentration is 12 g/dL, leukocyte count is 19,000/mm3, and platelet count is 225,000/mm3. A lumbar puncture is done; cerebrospinal fluid analysis shows  Which of the following infectious agents is most likely to have caused this patient's illness?

Quizplus · Accepted Answer

Eductional Objective: Fever; meningeal signs (eg, headache, neck stiffness); and cerebrospinal fluid that shows lymphocytic pleocytosis, a modestly elevated protein level (<150 mg/dL), and normal glucose are suggestive of aseptic meningitis.  Enteroviruses are the most common cause of aseptic meningitis.

A 5-Year-Old Boy Is Brought to the Emergency Department Because