A cold case of meningococcal meningitis.

摘要

A previously well 42-year-old man presented with 4 months of intermittent short-term memory loss, fever, headache, and 20 kg weight loss. He was febrile (38°C), abulic, and disorientated with fluctuating alertness requiring frequent prompting and supervision to do all selfcare tasks. He had impaired hand dexterity, mild midline ataxia, and subtle neck stiffness. The provisional diagnosis was an encephalopathy and antibiotics were deferred.