A 26-year-old army private is has severe headache and vomiting. These symptoms had developed 5 days previously during a 2-week field training exercise.

Question Number 0531

Question:
A 26-year-old army private is has severe headache and vomiting. These symptoms had developed 5 days previously during a 2-week field training exercise. On examination he has a fever of 38°C with marked photophobia and meningism. His conjunctivae are injected and he looks mildly jaundiced. WCC is elevated together with a raised PT and ESR. Further investigation reveals a mild degree of renal impairment. A Monospot test is negative. CSF examination shows a lymphocytic picture. What investigation will most helpful towards reaching a diagnosis?

a) Urine for microscopy and culture
b) CT scan
c) IgM antibodies
d) HIV serology
e) ECG


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