Case Challenge #7

A 26 year old Asian male presents with headache and neck stiffness. This is the 3rd episode in last 6 years since coming to US for school. Also notes oral ulcers in mouth and genital area. He takes no medications and denies recent sexual activity.

On physical exam, the patient is afebrile and nontoxic appearing. He has bilateral eye redness c/w uveitis, oral ulcers, and genital ulcers. Exam also reveals neck stiffness.

Labs: WBC 11k, Hgb 12, other wnl. CSF with 45 cells (85% Lymphs), protein 65, glucose normal. Gram stain is negative.

 

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