TB Case Discussion (2017-08-02)

30yo Ugandan male in US x 1yr presents with dry cough, weakness, weight loss, and intermittent headache and fever. By hospital day 1, patient is increasingly altered/confused. MRI reveals multiple ring-enhancing brain lesions. Started on TB treatment (RIF/INH/PZE/EMB) and by hospital day 12, LFTs, CXR, and AMS improved and repeat head CT show slight decrease in prominence of lateral ventricles. New developments by week 3-4 of hospitalization – hiccups, weight loss, and hyponatremia. Differential diagnosis for intractable N/V 7 wks into hospitalization?