Johnny Rose is a 74 yo raw-milk aficionado who recently discovered a love for consuming unpasteurized milk. He presents w/ several months of headache and fever. He now presents acutely appearing ill with projectile vomiting, He has a fever (106 F), myalgias, back pain, and areflexia.
CSF shows a WBC of 100 with 70% PMNs, protein of 150, and glucose of 20.
What is your DDx?
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