A 25 year-old patient with a Port-a-Cath implanted in the right chest complains of sudden onset severe neck pain and headaches with flushing central line and PN infusions. Labs and exam normal, including afebrile. Previous X-ray shows central line tip in at the cavo-atrial junction. Today, chest X-ray obtained (see below).
What is the most likely diagnosis?
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Cerebrl vascular accident
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Hypernatremia
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Central line malposition
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Pseuo-tumor cerebri
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Bactrial meningitis