A 68-year-old man in NY presents to the emergency department in late August with a 4-day history of fever and weakness. On exam, he has hyporeflexia and acute flaccid paralysis. His cerebrospinal fluid (CSF) profile shows pleocytosis, with predominance of lymphocytes and elevated protein.
He was recently cleaning out his grandson’s kiddie pool in his backyard. What is the diagnosis?

A 48-year-old man who received a kidney transplant 3 years ago presents to your clinic in February with a 2-month history of headache and low-grade fevers. His neurologic exam is normal and head computed tomography shows no acute changes. A lumbar puncture is obtained with a high opening pressure (24 cm H2O), cerebrospinal fluid (CSF) white blood cell (WBC) count of 180/μL (90% lymphocytes), protein of 200 mg/dL, and normal glucose. Exam of CSF shows this: What is the most likely diagnosis?