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ANSWER 7
(5) HERPES SIMPLEX VIRUS
SALIENT POINTS:
The clinical picture (fever, headache and behavioural change in a young, healthy person) and MRI (temporal lobe enhancement) are strongly suggestive of HSV encephalitis.
The PCR for HSV should be positive in almost all cases within the first 24 hours of presentation:
false negatives may occur if the lab is using an insensitive technique, or occasionally very early in the clinical course.
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