A middle-aged man with palmoplantar keratoderma (see Vignette 83) and who had a cadavaric renal transplant overseas 5 years ago presented with generalized tonic-clonic seizures followed by impaired consciousness. He subsequently recovered with full consciousness, and reported worsening headaches over the past week. Clinical examination showed that he was febrile at 38.4 degrees Celsius, but […]