Case Presentation
An 18-year-old Caucasian male with a past medical history of infectious
mononucleosis eight weeks ago presented with altered mental status. His
friends found him lying on the floor with a fever, groaning, combative,
and not able to be calmed with verbal measures. He was alert and
oriented as recently as the day prior. Emergency medical services (EMS)
brought him to an outside facility, where he was sedated and intubated
to protect his airway and transferred to our facility. Physical
examination demonstrated a fever of 39.16 ℃ (102.5℉), no
lymphadenopathy, mild hepatosplenomegaly, and nuchal rigidity. Initial
neurological examination under sedation was otherwise non-focal.