Table 1.
Selected Laboratory Values.
| Test | Results |
|---|---|
| Cerebrospinal Fluid Studies | |
| Color/Appearance | Colorless, clear |
| Red Blood Cell Count | Tube 1 429 (Tube 4 69) |
| Nucleated Cell Count | 197 (Differential: 1% Polymorphonuclear cells, 81% Lymphocytes, 9% Monocytes, 9% Other (plasma cells) |
| Glucose | 60 |
| Protein | 121 |
| Gram Stain and Culture | No organisms on gram stain and no growth at 48 hours on culture |
| Enterovirus PCR | No DNA sequences detected |
| Herpes Simplex Virus I PCR | No DNA sequences detected |
| Herpes Simplex Virus II PCR | No DNA sequences detected |
| Varicella Zoster Virus PCR | No DNA sequences detected |
| Epstein-Barr Virus PCR | No DNA sequences detected |
| Cytomegalovirus PCR | No DNA sequences detected |
| Lyme IgM, IgG Western Blot | No bands detected |
| Cryptococcus Antigen | Negative |
| VDRL | Non Reactive |
| Powassan IgM Capture ELISA | Positive |
| Powassan PRNT | 64 (POS Control > 320) |
| Serum West Nile IgM and IgG | Ab: <0.90, <1.30 (negative) |
| Fungal Smear and Culture | Calcofluor White Stain without yeast or fungal elements identified; culture with no fungus isolated at 4 weeks |
| AFB Smear and Culture | No AFB isolated at 6 weeks |
| Pathology Review | “Heterogeneous population of lymphoid cells, plasmacytoid lymphocytes and plasma cells which may be reactive in nature, but couldn't exclude a lymphoproliferative process” |
| Eastern Equine Encephalitis Virus | Eastern Equine IgG <1:4 (Antibody Not Detected) |
| Antibody Panel, IFA | Eastern Equine IgM <1:4 (Antibody Not Detected) |
| Western Equine Encephalitis Virus | Western Equine IgG <1:4 (Antibody Not Detected) |
| Antibody Panel, IFA | Western Equine IgM <1:4 (Antibody Not Detected) |
| California Encephalitis Virus Antibody | California IgG <1:4 (Antibody Not Detected) |
| Panel, IFA | California IgM <1:4 (Antibody Not Detected) |
| St. Louis Encephalitis Virus Antibody | St. Louis IgG <1:4 (Antibody Not Detected) |
| Panel, IFA | St. Louis IgM <1:4 (Antibody Not Detected) |
| Serum Studies | |
| Powassan IgM Capture ELISA | Positive |
| Powassan PRNT | 2660 (POS Control > 320) |
| Lyme Reflex | 0.65 Index (negative) |
| Babesia microti IgM, IgG | <1:20, <1:64 (negative) |
| Blood Parasite Prep, Thick Smear for Blood Parasite | None seen |
| Anaplasma Phagocytophilium PCR | Not Detected |
| Anaplasma Phagocytophilium IgM, IgG | <1:20, <1:64 (negative) |
| Mycoplasma pneumonia IgM | 0.43 (negative) |
| Mycoplasma pneumonia IgG | 0.20 (negative) |
| Urine Legionella Antigen | Negative |
| Quantiferon Gold | Nil 0.094 (no preexisting immune response) |
| Mitogen Nil 0.790 (healthy immune response) | |
| Ag Nil -0.041 (negative for TB) | |
| Plasma Herpes I and II PCR | Negative |
| VZV PCR | Negative |
Abbreviations: PCR Polymerase Chain Reaction; CSF = Cerebral Spinal Fluid; VDRL = Venereal Disease Research Laboratory; ELISA = enzyme-linked immunosorbent assay; PRNT = Plaque Reduction Neutralization Test; IFA = Immunofluorescence Assay.