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Powassan is a positive-sense, single-stranded, enveloped RNA virus that is a tick-borne transmitted by species, with groundhogs being the usual mammalian host. The virus is endemic to North America, with peak transmission during the summer and fall. The incubation period is 7-34 days, followed by a prodrome of flu-like symptoms. Although most infected individuals are asymptomatic, the virus can penetrate the CNS to produce a viral encephalitis. The key to the diagnosis is a positive serology. The patient is a 62-year-old male with a pas