<prompt> A 29-year-old man is seen in the office after returning from a hiking trip in Colorado. He complains of feeling unwell and reports symptoms of fever, myalgia, headache, and nausea. Two days ago, he noticed a rash on his wrists and ankles that has now spread to his body. He recalls having had numerous insect bites during his trip. On examination, his blood pressure is 9060 mmHg, pulse 100min, and respirations 20min. There are multiple 1-5 mm macules on his body and some of them have a hemorrhagic center consistent with a petechia. His neck is supple and fundi are normal. The heart sounds are normal, lungs clear, and legs are edematous. Cranial nerve, motor, and sensory examination is normal. A clinical diagnosis of Rocky Mountain Spotted Fever RMSF is made and he is started on appropriate therapy. Which of the following is the most common type of central nervous system CNS presentation in this condition?hemiplegiacranial nerve abnormalitiesparaplegiaencephalitis  <response>: Although all these can be manifestations of RMSF, encephalitis as manifested by confusion or lethargy is by far the most common CNS manifestation. It occurs in about one-quarter of cases, and can progress to coma. 