Virology USMLE Step 1 Practice Question
A 35-year-old previously healthy man develops sudden onset of severe headache, fever, neck stiffness, and altered mental status. CSF analysis shows lymphocytic pleocytosis with normal glucose and protein levels. Brain MRI reveals temporal lobe enhancement. PCR from CSF is positive for herpes simplex virus-1. Which of the following best explains the predominance of lymphocytes in the CSF?
Answer choices
- ADefective complement activation preventing neutrophil recruitment
- BHSV-induced damage to the blood-brain barrier allowing only lymphocytes to cross
- CCD8+ T cell response to infected neurons and glial cellsCorrect answer
- DBacterial coinfection that selectively recruits lymphocytes
- EViral suppression of neutrophil migration factors
- FMacrophage infiltration in response to cytokine release from infected tissue
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