MRCP2-4100
A 42-year-old woman presents with a headache, generalised aches and pains, lethargy and fevers. She has a medical history of type one diabetes and end-stage renal failure, and underwent a simultaneous pancreas-kidney transplant ten months ago. Four months ago, she was admitted with neutropaenia which led to the early cessation of her valganciclovir and a reduction in her immunosuppression. On examination, she appears pale, lethargic and unwell. Her temperature is 39.4 degrees Celsius, her pulse is 115 beats per minute and regular, her blood pressure is 102/59 mmHg, her respiratory rate is 22 breaths per minute and her oxygen saturations are 95% on room air. What is the most likely diagnosis?