5 Days Of Worsening in Medicine / Internal Medicine — 19yo Man | Infectious Diseases | SMLE Q#305

SMLE Question #305

Medicine / Internal Medicine Infectious Diseases
Last updated: February 2026
A 19-year-old man presents with 5 days of worsening headache and 2 days of neck stiffness. He reports intermittent low-grade fever for 1 month. He is alert and oriented with mild nuchal rigidity and no focal neurologic deficits. Lumbar puncture shows turbid cerebrospinal fluid with normal glucose, elevated protein, and lymphocytic pleocytosis. Which of the following is the most likely diagnosis?

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