3 Days Of High in Medicine / Internal Medicine — 22yo Woman | Infectious Diseases | SMLE Q#11258

SMLE Question #11258

Medicine / Internal Medicine Infectious Diseases

Objective: OBJ-349

Last updated: February 2026
A 22-year-old woman presents to the emergency department with 3 days of high fever, severe generalized headache, photophobia, and repeated vomiting. Over the last 12 hours, she became progressively drowsy. She is drowsy but arousable, with neck stiffness and positive Kernig and Brudzinski signs. Funduscopic examination shows no papilledema. Lumbar puncture results are shown below. What is the most likely diagnosis?

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