Infectious Diseases · NEET PG Preparation Medicine

A 28-year-old HIV-positive male with a CD4 count of 45/mu L presents with progressive headache, fever, and lethargy over two weeks. Fundoscopic exami…

Practice question from Infectious Diseases (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.

easy · MCQ · Q-E512E2

A 28-year-old HIV-positive male with a CD4 count of 45/μL45/\mu L presents with progressive headache, fever, and lethargy over two weeks. Fundoscopic examination reveals papilledema. Lumbar puncture is performed, and cerebrospinal fluid (CSF) analysis shows an opening pressure of 280 mm H2O280\text{ mm } H_2O, a white cell count of 20/μL20/\mu L (predominantly lymphocytes), protein of 85 mg/dL85\text{ mg/dL}, and a low glucose of 35 mg/dL35\text{ mg/dL}. Which of the following is the diagnostic test of choice for confirming the most likely etiology?

  1. A.CSF Cryptococcal Antigen lateral flow assayCorrect answer
  2. B.CSF VDRL test
  3. C.CSF PCR for Herpes Simplex Virus
  4. D.Acid-fast bacilli stain of the CSF sediment

Solution

The clinical presentation in a severely immunocompromised patient (CD4 < 100) with elevated opening pressure and lymphocytic pleocytosis is classic for cryptococcal meningitis. The CSF Cryptococcal Antigen (CrAg) lateral flow assay is extremely sensitive and specific, making it the diagnostic test of choice.

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