23rd May 2024

A 35-year-old female presents for the third time this year with a fever

A 35-year-old female presents for the third time this year with a fever, severe headache, photophobia, visual hallucinations and diplopia with nuchal rigidity. CT head is normal on each presentation. Lumbar puncture showed raised WCC, mostly lymphocytes, mildly elevated protein and normal glucose. There were large granular plasma cells noted under the microscope. She has been admitted with similar symptoms 3 times this year. Her symptoms usually resolve in 5 days.

What is the most likely diagnosis?

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