What is the most likely diagnosis for a patient with hydrophobia and neuropsychiatric symptoms after returning from Cuba?

The most likely diagnosis for a patient presenting with hydrophobia and neuropsychiatric symptoms after returning from Cuba is rabies. Rabies is a viral infection that affects the central nervous system, typically transmitted through the bite of an infected animal. The symptoms of rabies can include hydrophobia, which is characterized by a fear of water due to spasms in the throat muscles, as well as neuropsychiatric symptoms such as agitation, confusion, and hallucinations.

Given the travel history to Cuba, where rabies is known to exist, the likelihood of exposure to the virus increases. Other common symptoms of rabies include fever, headache, and paralysis, which can further support the diagnosis. The nature of the symptoms and the geographical context strongly point towards rabies rather than any of the other listed conditions.

Meningitis, while it can present with neurological symptoms, typically involves fever, neck stiffness, and a more acute presentation. Typhoid fever usually presents with sustained fever, gastrointestinal symptoms, and is less associated with neuropsychiatric features and hydrophobia. Schistosomiasis primarily involves gastrointestinal or urinary symptoms and does not typically present with such specific neurological manifestations or hydrophobia. Therefore, rabies stands out as the