5. Further Evaluation on hospital day #2

Further Evaluation on hospital day #2

  • Neuro-Oncology and ID consulted
  • T 101°F, BP 123/66, P 50
  • PE- not oriented to time or place
  • clinical impression: right temporal lobe encephalitis
  • differential diagnosis per ID:
    • HSV I
    • enterovirus 70, 71 (can mimic HSV)
    • EEE or other arboviruses (West Nile)
    • Japanese encephalitis
    • Cat scratch disease
  • ID recommended continuing acyclovir
  • patient underwent right temporal lobe biopsy that afternoon

Breakpoint #5

  • How would you interpret the following 4 slides from the brain biopsy?