Case Presentation: A 65-year-old man presents with five days of altered mental status, ataxia, and headaches. Four months prior, he traveled to Arizona. Soon after, he sought care for sinus pain, cough, weight loss, and diplopia. Lumbar puncture (LP) at the time showed 492 white blood cells (WBCs)/μl (80% lymphocytes), protein 509 mg/dL, and glucose [...]