Step 1

Microbiology 19

A 12-year-old boy is brought by his mother to the physician’s office. His mother reports that recently he has been acting strangely, has developed an unsteady gait, and has had two seizures. He was an excellent student until recently and occasionally he lashes out in aggressive fits of anger which is new for him. His family were refugees and recently moved to the United States from Afghanistan. His mother cannot remember which vaccinations he received as a child. She states that he has not been ill recently but remembers that as a young child he was ill with a red rash covering his face and body. Vital signs are normal. Physical examination shows a lethargic boy with an ataxic gait and 3+ reflexes in the lower extremities bilaterally.

Which of the following is the most likely diagnosis?

  • A) Mumps virus aseptic meningitis
  • B) Rabies
  • C) Rift Valley fever
  • D) Subacute sclerosing panencephalitis
  • E) Yellow fever


Samer Al-Humadi


Dr. Ted O'Connell