Case Report

A 30 year old male with a remote history of intravenous drugabuse (IVDA) and Hepatitis C was admitted in July 2008 with changes in mental status and a new right sided paresis. According to the family, the patient was in his usual state of health until approximately 2-3 weeks prior to admission when he developed headaches, generalized malaise, and fever to 101 degrees Fahrenheit after swimming in a lake. He was seen in an outside hospital emergency department, diagnosed with otitis media and subsequently discharged on prednisoneand ciprofloxacin. The morning of admission, the patient was found naked, nonverbal, confused and was subsequently taken again to an outside hospital emergency department where he was found to have right sided weakness, diagnosed with a new cerebrovascular accident (CVA) and transferred to TJUH for further management.