A 20-year old previously well man was brought to hospital a seizure. For three days he had complained of myalgia, lethargy and fever. On attempting to get out of bed at home, he had experienced lightheadedness with blurred and double vision and felt his legs were too weak to allow him walk. He then had a generalised tonic-clonic siezure, which lasted one minute. In the wake of the seizure he was confused and aggressive, requiring intravenous midazolam in the emergency department. He was febrile (101.3 F) with heart rate 85bpm, respiratory rate 12, and sO2 97% on room air.
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