Clinical Reasoning: A 42-Year-Old Woman With Mysterious Monocytic Meningitis

A 42-year-old woman with a history of migraine headaches and no other significant past medical presented daily headaches, cervicalgia, nausea over period 3 weeks. These were similar in severity to those that she had previously experienced. Presumptive treatment was administered released home. Three days later, her symptoms worsened developed double vision, unsteady gait, right-sided hearing loss. She reported fever or weight Residing the upper Midwest, leisure activities included hunting pheasant, deer, duck, regularly cooked ate wild game. traveled periodically southwestern state months prior presentation. In year preceding current illness, experienced multiple tick bites Lyme disease as teenager.