A 53-year-old lady was brought to the emergency department obtunded, agitated, and confused. She had been generally unwell for 1 week prior to admission with fever and lethargy. There had been no specific or localizing infective symptoms. She was clinically septic with a pyrexia of 39.3°C, had low a Glasgow Coma Scale score and altered neurology including bilateral up-going planters. She was admitted directly to the intensive care unit and managed for possible meningoencephalitis.

中文翻译：

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二尖瓣裂隙性心内膜炎伴有混淆。

一名53岁的女士被带到急诊室，她感到沮丧，激动和困惑。入院前1周，她总体一直感到不适，并伴有发烧和嗜睡。没有特异性或局部感染症状。她的临床脓毒症的发热为39.3°C，格拉斯哥昏迷量表评分较低，并且神经系统发生了改变，包括即将到来的双边种植园主。她被直接送进重症监护病房，并接受了可能的脑膜脑炎治疗。