A 34 year old male presents with a
history of dull headache of a few weeks duration. In addition he had felt
generally unwell with mild fever and lack of appetite. No past illnesses of
note, he was not on any drugs.
On examination you note that he is
ataxic and there is a sixth nerve palsy on the right side.
He has a CT scan which does not reveal
a space occupying lesion and this is followed by a lumbar puncture
Opening pressure 300 mm H2O
Protein 2.2 g/L
Cells 60 /mL (90% lymphocytes)
Glucose 0.5 mmol/L
Hb 13.5 g/dL
WBC 11 x109/L
Glucose 6.0 mmol/L
In this patient what is the most