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India HIV Clinical Case Discussion (2015-01-21)
44 yr old male HIV reactive - 12 yrs recently started on ART. Regimen - ZLN. Baseline CD4- 211 cells/cumm. Admitted to hospital (July) with c/o- jerky involuntary movements- Lt UL, Rt LL limb, blurring vision in both eyes. Weakness- Lt upper limb, difficulty in holding objects since last 2 months. MRI done.
VZV IgG antibodies - Positive. Patient is treated, improves and is discharged. (Aug)
Patient returns (end of Sept) with loss of memory, irrelevant talks x1 month, fever, extremity weakness, difficulty walking and transient blurring of vision. Dengue antigent - positive.
What's the differential diagnosis for this patient and subsequent management strategy?
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