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A correction has been published: N Engl J Med 1999;341(17):1314.

Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 340:127-135 January 14, 1999 Number 2
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Case 1-1999— A 53-Year-Old Man with Fever and Rapid Neurologic Deterioration
Timothy K. Vartanian, and Suzanne de la Monte

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 by Nachamkin, I.
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Presentation of Case

A 53-year-old right-handed man was admitted to the hospital in December because of fever and an altered mental state.

The patient had been well until two weeks earlier, when a cough and rhinorrhea developed. Three days before admission, he became lethargic, febrile, and forgetful. On the day before admission, he slept all evening and missed dinner. On the morning of admission, he was barely responsive. He was taken to another hospital, where a lumbar puncture was performed (Table 1). Ceftriaxone was administered, and he was transferred to this hospital.

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Table 1. Findings on Lumbar Puncture.

 
The patient worked in a . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Timothy K. Vartanian's Diagnosis

Pathological Discussion

Anatomical Diagnosis

References


Related Letters:

Case 1-1999: Acute Hemorrhagic Leukoencephalitis
Nachamkin I., Zünkeler B., Chaudhuri A., Behan P. O., Young A. B., Vartanian T.
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N Engl J Med 1999; 341:1314-1316, Oct 21, 1999. Correspondence

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