Table 1.

Clinical course of neurotoxicity and patient covariates at our facility

Date	Mental status	Imaging	Laboratory and microbiology findings	SCr (mg/dL)	CrCl (Cockcroft-Gault) (mL/min)
Hospital day 0	Oriented to person, city, but not oriented to date, state or situation.	CT brain XR chest Renal ultrasonography	-Skin herpes simplex and VZV DFA negative -Rapid shell viral culture negative for herpes simplex and VZV -Urinalysis: Specific gravity 1.017, protein screen positive, glucose screen negative, no ketones, trace blood, 2–5 granular casts, >10 hyaline casts, 0 WBC, 0 RBC -Urine culture: 2,000 cfu/ml Gram Negative Rods	2.54	26.44
Hospital day 1	Fluctuating mental status	CT spine MR brain		2.52	26.65
Hospital day 2	Somnolent, slightly more confused. After a few attempts was able to give his own name. Not oriented to location. Followed some commands but resisted exam.	EEG	Blood cultures: MSSA	2.42	27.75
Hospital day 3	Inappropriate reactions (e.g. hiding under bedsheets)	CT abdomen, chest, pelvis		2.36	28.46
Hospital day 4	Alert and oriented × 0–1 to self. Mental status and ability to follow commands progressively declining		-Skin Herpes simplex and VZV DFA negative -Rapid shell viral culture negative for herpes simplex and VZV	2.35	28.58
Hospital day 5	Disoriented, flat affect, non-verbal, minimally responsive to vocal cues, responsive to painful stimuli and loud voice only.		CSF cell count with differential: 37 WBC (83% lymphocytes, 15% monocytes, 1% macrophages, 1% neutrophils); 4 RBC CSF glucose: 90 CSF gram stain and culture: gram stain negative, culture with no growth at 72 hours CSF protein: 72 CSF VZV PCR: 912 copies/mL Blood glucose: 146	2.36	28.46
Hospital day 6	Non-verbal, somnolent	MRA head MR spine		2.51	26.76
Hospital day 7	Awake and interactive, follows commands and responding to verbal cues, albeit mostly with inappropriate responses. Notes earlier hallucinations and red vision (“only seeing things in red”)			2.41	27.87
Hospital day 8	Fully alert and oriented this morning, more interactive			2.21	30.39
Hospital day 9	Patient is fully oriented, alert and communicative	Transesophageal echocardiography		1.99	33.75
Hospital day 10	Alert and oriented, more confluent speech with less word finding			1.96	34.27

^**All CTs and MRs were done without contrast dye. All creatinine clearances calculated using weight of 62kg.

Abbreviations: CSF: cerebral spinal fluid; DFA: direct fluorescent antibody; Echo: Echocardiogram; EEG: Electroencephalography; MR: Magnetic Resonance; MSSA: methicillin-sensitive Staphylococcus aureus; PCR: polymerase chain reaction; RBC: red blood cells; VZV: Varicella zoster virus; WBC: White blood cells; XR: X-Ray