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A 21 year old man was admitted to hospital presenting with low grade fever (37.7°C), slight meningeal irritation, headache, visual hallucinations, dysarthria, insomnia, gait and limb ataxia, and a postural tremor.
There was no relevant history except for a fall into a river after a fight 2 weeks before admission. There were only a few superficial skin lesions, no medical attention was sought. The patient denied the use of recreational drugs.
Brain CT was normal. A lumbar puncture was performed showing 72 white blood cells/mm3 (84% monocytes and 16% polymorphic neutrophils), and …
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