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28th May 2025
A 19-year-old male patient comes into A&E with a fever and headache, which has now progressed to fluctuating confusion, amnesia, unusual behaviour, and multiple seizures.
A 19-year-old male patient comes into A&E with a fever and headache, which has now progressed to fluctuating confusion, amnesia, unusual behaviour, and multiple seizures.
A CT head was done initially. This was followed by an MRI head which showed:
The CSF findings are:
| Finding | Result | Reference Ranges |
|---|---|---|
| WCC | 120 cells/ µL | 0 – 5 cells/µL |
| Cell differential | Lymphocytic pleocytosis | — |
| RBC | 400 cells/mm3 | 0-10 cells/mm3 |
| Protein | 0.21 g/L | 0.15 – 0.45 g/L |
| Glucose | 2.3 mmol/L | 2.8 – 4.2 mmol/L |
Of the options below, which is the most likely infectious cause of epilepsy in this case?
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