Event
10 days prior to admission	Onset of fever, confusion, and fatigue
7 days prior to admission	Transient loss of consciousness
Day 0	Patient presents to the emergency room with fever and fatigue. He is alert and haemodynamically stable. Twelve-lead electrocardiogram (ECG) and non-contrast head computed tomography (CT) are unremarkable
Day 1	Admission to internal ward Initial fever workup does not identify the source of patient's symptoms
Day 2	Patient is placed on 24 h Holter ECG Gradual cognitive impairment is noticed Head CT angiography demonstrated changes at the left hemispheric blood vessels and lumbar puncture confirms herpes simplex encephalitis Patient is started on parenteral Acyclovir
Day 3	Syncopal episode noticed by staff Holter documents five episodes of sinus arrest; prominent ones being 11 and 32 s Patient is transferred to intensive cardiac care unit
Day 5	Cognition is fully restored, fever subsides
Day 7	Patient is transferred back to internal ward, completes 14 days of parenteral Acyclovir treatment
Day 9	Subsequent Holter ECG revealed normal heart rate without any evidence of bradycardia
Day 16	Upon discharge an implanted loop recorder was considered but rejected by the patient
5 months later	A follow-up Holter ECG documented normal heart rate and no evidence of bradycardia
12 months follow-up	Patient is doing well and had no further episodes of syncope or documented bradycardia