Medicine · Neurology (Stroke, Epilepsy, Parkinson's, MS, MG, GBS, Meningitis)

A 50-year-old man presents with fever, confusion, and olfactory hallucinations over 5 days. MRI brain shows T2/FLAIR hyperintensity in the medial temporal lobes bilaterally. What is the most urgent and specific treatment?

  • A Ampicillin
  • B Amphotericin B
  • C Acyclovir
  • D Doxycycline
Correct answer: C. Acyclovir

Explanation

Herpes Simplex Encephalitis affects the temporal lobes and limbic system, causing hallucinations and confusion. High-dose IV Acyclovir must be started immediately without waiting for PCR results, as delay increases mortality. Ampicillin covers Listeria, which affects the brainstem.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.

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