As in this case, the lack of a specific diagnosis leaves the clinician
uncertain how to predict or alter the course of the
disease. The clinical picture of rapidly progressive coma suggested
either infectious or autoimmune-mediated encephalitis,
but the CSF profile was more concerning for an infectious
etiology. Further immunosuppression for presumed autoimmune
or paraneoplastic limbic encephalitis was considered
though not initiated early on due to concern for potential TB
meningoencephalitis.