A 24-year-old man presents with 5-day progressive fever (38.9°C), headache, and altered mental status. Vital signs show HR 102, BP 128/76, RR 18, SpO2 98% on room air. Brain MRI demonstrates bilateral temporal lobe T2/FLAIR hyperintensity with enhancement and periventricular white matter lesions. CSF analysis reveals lymphocytic pleocytosis (68 cells/μL), normal glucose (55 mg/dL), and negative HSV-1 PCR. He denies recent vaccinations. Which of the following is most likely?
- A)Herpes simplex encephalitis
- B)Anti-NMDA receptor encephalitisGABARITO
- C)Multiple sclerosis with superimposed infection
- D)Bacterial meningitis
- E)Acute demyelinating encephalitis
Explicação
Anti-NMDA receptor encephalitis presents with fever, psychiatric symptoms, and altered mental status. Bilateral temporal involvement with normal glucose CSF and negative HSV PCR are characteristic, distinguishing it from HSV encephalitis. The presence of white... Ver explicação completa e trilha adaptativa →