Repeated USMLE Questions Step 1- 199

A 5-year-old boy is brought to the ER by his mother. He has fever, cough, lethargy, headache and neck pain. On examination, his temperature is 103.2 F, his neck is rigid and tender and Kernig sign is positive. CSF is clear and significant for glucose 60 mg/dL, protein 80 mg/dL, no bacteria or pus cells and lymphocytes count is 70%.

What is the most likely causative organism?

A- Echovirus

B- Neisseria Meningitidis

C- Streptococcus Bovis

D- Streptococcus Pneumonia

E- Staphylococcus Aureus

Answer






History and clinical picture suggest meningitis. CSF analysis suggests viral infection rather than bacterial. Echovirus is the only choice that most likely the causative organism in this case.

The correct answer is A