HIV neuro complications

Question 1

Toxoplasmosis - presentation

Answer 1

Headache, confusion, drowsiness
CT: multiple ring enhancing lesions +/- mass effect

Question 2

Toxoplasmosis - treatment

Answer 2

Sulfadiazine and pyrimethamine

Question 3

CNS lymphoma - presentation

Answer 3

Associated with EBV
CT: single homogenous enhancing lesion
Thallium SPECT positive

Question 4

Encephalitis - cause and CT

Answer 4

CMV or HIV
CT: oedematous brain

Question 5

Cryptococcus presentation

Answer 5

Headache, fever, malaise, N&V,seizures, focal neuro deficit

Question 6

Cryptococcus - LP and CT

Answer 6

LP: high protein, reduced glucose, lymphocytes, India ink +
CT: meningeal enhancement, cerebral oedema

Question 7

Progressive multifocal leucencephalopathy - cause

Answer 7

JC virus –> widespread demyelination

Question 8

Progressive multifocal leucencephalopathy - presentation

Answer 8

Subacute onsety, behavioural changes, speech, motor or visual impairment

Question 9

Progressive multifocal leukencephalopathy - imaging

Answer 9

CT - single or multiple lesions, no mass effect, not enhancing
MRI - high signal demyelinating white matter