title: An unusual cause of meningitis.
abstract: A 57 year old man patient presented with fever and frontal headache. He had a background history of sero-positive rheumatoid arthritis which was well controlled on immunomodulatory disease modifying anti-rheumatoid drugs (DMARDS) including methotrexate and lef lunomide. Six months earlier he had returned from Massachussetts in the USA after a one year period of residence there. On examination his vital signs were within normal limits and he was afebrile with a temperature of 36.1oC. His left elbow joint was warm, tender and swollen; examination was otherwise normal.
authors.affiliation: SHO, General Medicine, Hull Royal Infirmary.
authors.forename: T M
authors.initials: TM
authors.lastname: Pasha
authors.forename: K
authors.initials: K
authors.lastname: Trower
authors.forename: D
authors.initials: D
authors.lastname: Bhatia
authors.forename: H K
authors.initials: HK
authors.lastname: Thaker