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A previously healthy 53-year-old man presented with headache, blurred vision, and pulsatile tinnitus. A lumbar puncture demonstrated meningitis with increased intracranial pressure (opening pressure, 37 cm H2O), with a white-cell count of 154 per cubic millimeter, a protein level of 68 mg per deciliter (0.68 g per liter), and a glucose level of 75 mg per deciliter (4 mmol per liter). A serum sample was positive for West Nile virus–specific IgG antibody. Results of brain magnetic resonance imaging and magnetic resonance angiography were normal. Initial ocular examination revealed a visual acuity of 20/25 in the right eye and 20/20 . . . [Full Text of this Article] |
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