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Case 3: A 36-Year-Old with Headache, Fever, and a Seizure

You answered:

B Approximately 10% of primary central nervous system lymphomas in patients with AIDS are associated with Epstein-Barr virus (EBV). Performing cerebrospinal fluid (CSF) PCR does not usually provide useful information.

This answer is incorrect. More than 75% of primary central nervous system (CNS) lymphomas in patients with AIDS are associated with Epstein-Barr virus (EBV). A CSF specimen can provide useful information, as a positive PCR for EBV strongly suggests a diagnosis of primary CNS lymphoma.

Choose another answer:

A The presence of more than one mass lesion rules out central nervous system lymphoma.
C Based on the clinical presentation and the radiographic findings, the most likely diagnosis is primary central nervous system lymphoma. Radiation therapy should emergently be arranged.
D Based on the clinical and radiographic findings, the most likely diagnosis is Toxoplasma encephalitis. Empiric therapy with pyrimethamine (Daraprim) plus sulfadiazine plus leucovorin should be started.

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