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 Best of Five 2.231

 

   

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BOF: 2.231

A 34 year old male presents with a history of dull headache of a few weeks duration. In addition he had felt generally unwell with mild fever and lack of appetite. No past illnesses of note, he was not on any drugs.

On examination you note that he is ataxic and there is a sixth nerve palsy on the right side.

He has a CT scan which does not reveal a space occupying lesion and this is followed by a lumbar puncture

CSF

Opening pressure 300 mm H2O

Protein 2.2 g/L

Cells 60 /mL (90% lymphocytes)

Glucose 0.5 mmol/L

 

Blood

Hb 13.5 g/dL

WBC 11 x109/L

Glucose 6.0 mmol/L

 

In this patient what is the most likely diagnosis?

a)      Viral meningitis

b)      Viral encephalitis

c)      Bacterial meningitis

d)     Tuberculous meningitis

e)      Froinís syndrome

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