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EM@3AM: Encephalitis

An 18-year-old female presents with confusion, seizures, and fever. Patient is unable to provide history, but her mother states that she began noticing confusion 2 days ago, and the patient expressed head discomfort yesterday. The patient appears lethargic and does not follow commands, and she is febrile and tachycardic. She has nuchal rigidity and is hyperreflexic with upgoing toes bilaterally. What is the patient's diagnosis? What is the next step in your evaluation and treatment?