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A 30-year-old woman, previously well, presented to an outside hospital after being found lying on her bedroom floor, with a history of confusion, headache, déjà vu and fever. She had been discharged the day before having had normal investigations for headache, including a CT and MR scans, both read as normal. Laboratory studies showed a urinary tract infection with leucocytosis, but she was afebrile. She was discharged home with medications to treat her urinary tract infection and headache.
During a second presentation to the outside hospital, her cerebrospinal fluid (CSF) showed a pleocytosis and she was started on acyclovir, empirically to treat viral encephalitis. EEG showed right-sided sharp waves. Her neurological condition further deteriorated and she was intubated for airway protection and transferred to the Presbyterian Hospital. On examination, she was …
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