A man in his 40s with headache and blurred vision.

* Current address: Department of Neurology Drammen Hospital Vestre Viken Health Authority Headache with increased cell number in the spinal fluid, fever and meningeal thickening immediately gives rise to associations with bacterial meningitis. When there is sub-acute onset of symptoms and an atypical course of disease with poor response to antibiotics, however, differential diagnostic possibilities should be considered. The patient is man in his 40s with severe complications of a rare meningeal condition.