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#idboardreview 60 M sarcoidosis w/ 2wks x fever, unsteady gait, fluctuating arm weakness/dysarthria, horizontal diplopia. CSF 200wbc 90%lymph, shock on vanc,cefepime,amp, ampho, rapid inc brain edema➡️death. Diagnosis? #medEd #idmedEd #idtwitter 
#acanthamoeba rapidly progressive meningoencephalitis & uncontrollable cerebral edema, resulting in death from increased intracranial pressure w/in few days after presentation & no response to broad-spectrum abx, antiviral, antifungal, and immune-modulation therapies
