Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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A 45-year-old man with HIV/AIDS for 10 years presented with generalized weakness, headache, and blurring of vision for 2 months. Sputum was positive for acid-fast bacilli. CSF analysis showed raised proteins (331 mg/dL), low glucose (7 mg/dL), and lymphonuclear pleocytosis (85%). CD4 count was 68. Initial brain MRI was performed and the patient was started on antitubercular therapy (ATT) followed by antiretroviral therapy (ART). One and a half months later, the patient presents with neurologic worsening (headache, vomiting, altered sensorium). CD4 counts have risen to 316.
