A 21-year-old man is brought to the emergency department by hi | Surgery collections Videos and quizez 2021

A 21-year-old man is brought to the emergency department by his family after a witnessed generalized tonic-clonic seizure. His sister says that the patient has never had a previous seizure but has had progressive headaches, fever, nasal congestion, and rhinorrhea over the last 3 weeks. He has no chronic medical problems and does not use alcohol, tobacco, or illicit drugs. Temperature is 38.9 C (102 F), blood pressure is 130/85 mm Hg, and pulse is 96/min. The patient is drowsy and postictaL CT scan of the head with intravenous contrast reveals a 3-cm ring-enhancing lesion in the left frontal lobe. There are air-fluid levels and mucosal edema in the paranasal sinuses. Rapid HIV testing is negative.