Emergency department due to a generalized tonic-clonic seizure

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. Electroencephalogra m 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?

  • Q A. Abnormal protein in an infected animal brain
  • Q 8. Infectious oocysts in feline feces
  • Q C . Neurotropic virus acquired from an infected animal bite
  • Q D. Parasite eggs in contaminated food or water
  • Q E. Sporozoite inoculation from a mosquito bite
  • Q F. Nasal mucosal penetration by fresh-water amoebas

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