5th May 2024

A 45-year-old woman presents with a 3-day history of fever, headache, and altered mental status.

A 45-year-old woman presents with a 3-day history of fever, headache, and altered mental status. She has a history of genital herpes but no recent outbreaks. Examination reveals neck stiffness and photophobia. Lumbar puncture shows lymphocytic pleocytosis, and PCR testing confirms herpes simplex virus encephalitis.

Which is the most appropriate initial management?