“…In comparison, cases with encephalitis as the initial symptom were mainly distributed in the United States, with death occurring within days to months [1 , 9 , 10] . In the reported cases, the skin lesions most commonly involved the maxillofacial region, especially around the nasal alar, and presented as localized red plaques [9 , 11] . The main clinical symptoms of central nervous system invasion include fever, headache, vomiting, epilepsy, altered consciousness, and speech disorder [9] .…”