A 20-Month-Old Girl With Fever, Seizures, Hemiparesis, and Brain Lesions Requiring a Diagnostic Brain Biopsy

We report a case of a 20-month-old girl with atypical presentation of a fairly common condition. She presented with acute onset of fever, seizures, and hemiparesis. Her cerebrospinal fluid showed total nucleated cells 10/mm 3 with lymphocyte dominance. Polymerase chain reaction was negative for herpes simplex virus. Computed tomography of head showed a cerebral hemorrhage of the left frontal lobe and small subarachnoid hemorrhage in the right frontal region. Brain magnetic resonance imaging revealed multiple foci of hyperintensity in bilateral parietal lobes and right basal ganglia. She remained clinically stable without a specific therapy. Her diagnosis was made after a brain biopsy.