NYMC Faculty Publications

Clinical Reasoning: A 64-Year-Old Man With Confusion, Nausea, Seizure, and Fever

Author Type(s)

Resident/Fellow, Faculty

DOI

10.1212/WNL.0000000000213659

Journal Title

Neurology

Document Type

Article

Publication Date

6-6-2025

Department

Neurology

Disciplines

Medicine and Health Sciences

Abstract

Evaluating patients with encephalitis is common, but it can be complicated in immunocompromised patients. In this case, a 64-year-old man with a medical history of multiple myeloma and previous Lyme disease presented with acute onset of confusion, nausea, and fever; developed generalized tonic-clonic seizures; and subsequently became comatose. This case highlights the importance of thinking broadly beyond common viral and bacterial encephalitides and developing a comprehensive differential diagnosis.

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