Headache, Diplopia and Fever in a 12 year old

by

G.N. Lakshminarayan

 

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 membersí thoughts?

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(c) 2008 M.H. Rivner

March 31, 2008