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Figure 1. A 62-year-old previously healthy woman was admitted with a three-week history of fever, fatigue, night sweats, headache, and vomiting and a two-month history of progressive weight loss. She reported memory loss, poor concentration, and insomnia. On neurologic examination, she was confused and answered questions slowly but had no stiffness of the neck, cranial-nerve palsies, or pyramidal signs. Cerebrospinal fluid analysis revealed pleocytosis (340 white cells per cubic millimeter, 80 percent lymphocytes), elevated protein levels (2.4 g per liter), and low glucose levels (38 mg per deciliter [2.1 mmol per liter]). A plain film and a computed tomographic . . . [Full Text of this Article] |