Demyelinating Diseases USMLE Step 1 Practice Question
A 29-year-old woman with multiple sclerosis on natalizumab therapy presents with acute severe headache, fever (38.9Ā°C), and confusion. Vital signs show BP 118/76, HR 102, RR 18, SpO2 98% on room air. CSF analysis reveals lymphocytic pleocytosis (180 cells/Ī¼L) with low glucose (28 mg/dL) and normal protein. Brain MRI demonstrates multifocal white matter lesions with enhancement. She denies focal neurologic deficits. Which of the following is the most likely diagnosis?
Answer choices
- ABacterial meningitis
- BViral encephalitis
- CMS disease exacerbation
- DProgressive multifocal leukoencephalopathyCorrect answer
- EDemyelinating leukoencephalitis
- FTuberculosis meningitis
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