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An 18-year-old man who had been in good health had malaise, a high temperature, and a nonproductive cough. Ten days later, he had a headache, double vision, and paresthesias of the right side of the body, predominantly in the upper and the lower limbs. On admission to the hospital, he was somnolent and febrile, with a rigid neck. The next day, patellar reflexes became asymmetric, with an extensor left plantar reflex. The patient became unconscious
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