Fungal and Parasitic Infections USMLE Step 1 Practice Question
A 45-year-old man with untreated HIV (CD4 20 cells/μL) presents with fever (39.2°C), headache, and confusion for 2 weeks. Vital signs show BP 108/70, HR 98, RR 16, SpO2 98%. CSF analysis reveals protein 250 mg/dL, glucose 35 mg/dL with serum glucose 120 mg/dL, and lymphocytic pleocytosis. India ink stain is positive. No focal neurologic deficits are noted. Which medication is the best initial treatment?
Answer choices
- AAmphotericin B followed by fluconazoleCorrect answer
- BTrimethoprim-sulfamethoxazole
- CFluconazole monotherapy
- DAcyclovir and cefotaxime
- ECeftriaxone and vancomycin
- FItraconazole followed by voriconazole
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