{"ops":[{"insert":"A previously healthy 45-year-old man presents with a fever of 39\u02daC (102.2 \u02daF) for two days. He also experienced nausea, photophobia, and a continuous generalized headache for one day. There is no history of weakness, vomiting, loss of consciousness, or seizures.\n \nHe returned from Vietnam three days prior to the onset of symptoms. He had spent two weeks there as a tourist. He was bitten by insects multiple times, ingested seafood, and drank unboiled fresh water.\n \nThere is no history of allergies. He only drinks socially, and does not smoke or use ilicit drugs. A complete blood count, liver and renal profiles, urinalysis, ECG, and chest x-ray are all unremarkable.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-250_en.png"}},{"insert":"\n"}]}
2
Investigate
Blood cultures
{"ops":[{"insert":"Culture results will be available in 48 to 72 hours.\n"}]}
Lumbar puncture
{"ops":[{"insert":"Opening pressure: 25 cmH2O (10-20)\nAppearance: mildly cloudy\nWBC: 500 cells\/uL (0-5)\n Eosinophils: 44% \n Lymphocytes: 35%\n Monocytes: 11%\n Plasma cells: 10%\nProtein: 97 mg\/dL (\u003C45)\nGlucose 60 mg\/dL (\u003E50% plasma glucose)\nGram stain: negative\nZiehl-Neelsen stain: negative\n \nA random plasma glucose collected at the same time is 110 mg\/dL (\u003C180).\n"}]}
