Question | Discussion | References | CME Credit

Case 1: A 39-Year-Old with Headache, Fever, and Confusion

You answered:

A The diagnosis of Toxoplasma encephalitis is the most likely diagnosis even though the contrast brain CT is normal; approximately 40% of AIDS patients with Toxoplasma encephalitis will have a normal contrast brain CT.

This answer is incorrect. More than 90% of AIDS patients with Toxoplasma encephalitis will have one or more mass lesions observed on contrast brain CT scan.

Choose another answer:

B The patient's clinical history is compatible with cryptococcal meningitis. The diagnosis of cryptococcal meningitis should not be ruled out with only 7 leukocytes/mm3 found in the cerebrospinal fluid.
C The clinical history is most compatible with progressive multifocal leukoencephalopathy (PML). A cerebrospinal fluid test positive for Epstein-Barr virus (EBV) would be diagnostic of PML.
D The patient's findings suggest a diagnosis of central nervous system lymphoma. The diagnosis is confirmed with a cerebrospinal fluid test positive for human herpes virus 8.

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