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30-Year-Old Immunocompromised Man With Fever, Headache, and History of Encephalopathy

      A 30-year-old man presented to the emergency department late in the evening, accompanied by his parents, with a 1-week history of fever, headache, loose stools, and decreased oral intake and a 1-day history of acute confusion. His past medical history was significant for neurofibromatosis type 2 with bilateral acoustic schwannomas, multiple spinal and intracerebral meningiomas, spasticity with chronic limb contractures, hydrocephalus status post ventriculoperitoneal shunt placement, and recurrent sinusitis. He had no known drug allergies. Medications included bevacizumab 7.5 mg/kg every 6 weeks for treatment of meningiomas and fluticasone propionate nasal spray daily. The patient had no sick contacts and a negative SARS-CoV-2 test result 1 day before admission. He had no recent travel history and lived at home with his parents and siblings; his mother attended all medical appointments with him and was his primary caregiver. He did not smoke or drink alcohol.
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      CORRECT ANSWERS: 1. d. 2. e. 3. a. 4. d. 5. e.