question: Q:A 9-year-old boy presents to the emergency department with a 12 hour history of severe vomiting and increased sleepiness. He experienced high fever and muscle pain about 5 days prior to presentation, and his parents gave him an over the counter medication to control the fever at that time. On presentation, he is found to be afebrile though he is still somnolent and difficult to arouse. Physical exam reveals hepatomegaly and laboratory testing shows the following results:
  
  Alanine aminotransferase: 85 U/L
  Aspartate aminotransferase: 78 U/L
  
  Which of the following is the most likely cause of this patient's neurologic changes?? 
  {'A': 'Bacterial sepsis', 'B': 'Cerebral edema', 'C': 'Drug overdose', 'D': 'Subarachnoid hemorrhage', 'E': 'Viral meningitis'},