A 26 year-old Cambodian monk presents with complaints
of a three week history of fatigue and malaise. The patient
reports that four days prior to presentation he developed
fevers to 103F, chills and a severe headache. The patient
reports that he had returned from Cambodia one week
prior to initiation of symptoms. He denies any sick
contacts and denies any neck stiffness, photophobia,
visual changes or abdominal pain. The patient does report
diarrhea for one week with approximately 8-10 bowel
movements per day. The patient denies any risk factors
for HIV. The patient had been seen in the Emergency
Department one day prior to admission. His temperature
was 102F, pulse was 110 beats per minute, respirations
were 20 breaths per minute and blood pressure was
110/80mm Hg. A lumbar puncture was performed,
blood cultures and stool cultures were sent. The patient
was discharged with a prescription for Percocet.