A semiconscious white youth, 16 years old, was admitted to Georgia Baptist Hospital on July 11, 1959, at 11:30 a.m. His mother said that he had been in good health until two nights previously at which time he came home from a swimming party complaining of a headache, became nauseated, and vomited several times. The next day he was no better, so the family physician was called; he prescribed tetracycline to be taken orally. That night the patient was also restless; he was feverish and had some trouble talking. The following morning there was difficulty in arousing him and he was brought to the hospital.
The patient was a well-developed, muscular young man with a tender swollen area over the left frontal sinus about the size of a half dollar. Reflexes were generally hyperactive with moderate nuchal rigidity, and partial paralysis of the left facial nerve was noted. Retinal veins