Cerebrospinal fluid (CSF) shows neutrophilic pleocytosis often greater than 500 ml, elevated erythrocyte count, and elevated protein [14] , which are findings similar to the profile expected in herpes simplex virus (HSV) encephalitis or subarachnoid hemorrhage [30] . Gram-stain shows copious largegram positive rods with or without endospores. Blood cultures are positive in most patients with meningoencephalitis.