12th June 2023

A 32-year-old man is admitted to the acute medical unit with fevers and shortness of breath

A 32-year-old man is admitted to the acute medical unit with fevers and shortness of breath. His bloods show raised inflammatory markers and a chest x-ray is clear. He is treated with broad spectrum antibiotics initially. After 24 hours, he develops a left hemiparesis with dysarthria. A CT brain shows changes in both cerebral hemispheres.

Which of the following options is most likely to yield the exact cause for this man’s deterioration?