This 12 year old boy developed headache, intermittent double vision and fever
about a week ago. He was admitted in our hospital about three days ago. He had
mild neck stiffness and generalized muscle tenderness. He is conscious and well
oriented. No nystagmus or ocular palsy. Fundi were normal. His total WBC count
is only 6,000 c/cmm. LP showed mild protein elevation with 600 cells, all
lymphocytes. CT Scan of the brain both plain and contrast was normal. His MRI is
interesting which I have posted. His temperature spikes to 100 to 102 dF once a
day. I have started the patient on ribavirin and acyclovir with methyl
prednisolone. What are other members’ thoughts?
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(c) 2008 M.H. Rivner
March 31, 2008