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A 70-Year-Old Male Presents to the Emergency Room with Headache

Question 21

Multiple Choice

A 70-year-old male presents to the emergency room with headache, nausea, fever, lethargy, and confusion over the past three days. A cerebrospinal fluid is sent to the laboratory. Laboratory testing includes:
Direct CSF Gram stain: no organisms seen with rare white blood cells
CSF culture: no growth at 48 hours
Blood culture: no growth at 48 hours
CSF glucose: 60 mg/dl
CSF protein: 62 mg/dl
CSF White blood cell count: 233 lymphocytes
Given these results, what patient history information may be most helpful in
Narrowing down the possible causative agent?


A) Has the patient been exposed to mosquitoes and ticks recently?
B) Has the patient been swimming in fresh water recently?
C) Has the patient recently had the mumps?
D) Does the patient work at a daycare facility?

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