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A 47-year-old male named Akio Nakamura presents to the ED at 2223 hours. He is an engineer for a large firm in the United States. He stated that he recently came back from a business trip in Central Asia where he had been working on a new water infrastructure project. He states that he worked mainly outdoors, supervising project sites. Akio also says he had felt fine for most of the trip, but shortly before leaving to travel home, he felt a little sick. Upon further questioning, the patient states that he decided to come to the ED because he had a persistent headache over the past few days that has become unbearable, and his partner stated that he became slightly confused and disoriented this evening. Other issues Akio is having is nausea to the point where he has been vomiting, further exacerbating his headaches. The patient when asked, states that he has been more tired than usual and has been experiencing diarrhea. The patient's vital signs are stable yet elevated at this time with normal oxygen saturation. The physician discovered that the patient also has neck swelling and stiffness. The physician orders a series of tests. Out of all.
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