The patient presented with worsening headache, nausea, photophobia, fever and chills. Physical examination revealed a red rash on the forehead with vesicles, lymphadenopathy and mild nuchal rigidity. CSF analysis showed an elevated white blood cell count with lymphocytes and normal glucose. PCR testing was negative for HSV and VZV. The presentation is consistent with viral meningitis likely caused by enterovirus given the aseptic findings on CSF analysis.

2. CC:headache HPI:patient came to the ER because of worsening headache, that started 5 days ago, on the left side of the head and now radiating to the right side of the head, scoring 9/10, pressure like, continues ,gradual increasing, tylanol could not relief it.

5. ROS: GEN: fatigue, subjective weight loss, fever, chills, night sweats. Skin: rash on her forehead, left side. Ears: no hearing loss, no tinnitus. Mouth: no sore throat. Chest: no chest pain, palpitations, no SOB. GI:N/V, constipation. GU: none. Neuro: numbness in the left hand, no seizure, no paralysis, no memory loss.