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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 335:1587-1595 November 21, 1996 Number 21
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Case 36-1996— A 37-Year-Old Man with AIDS, Neurologic Deterioration, and Multiple Hemorrhagic Cerebral Lesions
S.A. Lipton, and M.J. Ma

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Presentation of Case

A 37-year-old right-handed man with the acquired immunodeficiency syndrome (AIDS) was admitted to the hospital because of increasing confusion and disorientation.

The patient had tested positive for antibodies against human immunodeficiency virus type 1 (HIV-1) several years earlier. Thirty-eight months before admission the CD4+ cell count was 200 per cubic millimeter, and zidovudine treatment was begun. Seven months later he was treated successfully for Pneumocystis carinii pneumonia. Ten months before admission a disseminated varicella–zoster rash developed and was complicated by abdominal pain attributed to pancreatitis. Trimethoprim–sulfamethoxazole, acyclovir, fluconazole, and rifampin were added to the treatment regimen. In the next month . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Stuart A. Lipton's Diagnoses

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