Case Challenge #1

brain-on-fire

A 27-year-old woman presents with sudden onset agitation and delirium. In the emergency department, she has incoherent speech and lashes out violently at staff. She is initially febrile (38.7ºC). She is admitted to the ICU for observation and after two days is intubated for deteriorating mental status. Prior to intubation, she is noted to have labile blood pressure alternating between hypertension and hypotension.

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