Mental Status Changes
 
Introduction
Acute Confusion
   Infectious
   Metabolic
Cases
   Headache
   Fever & Confusion
   Focal Weakness
   Nice Doggie
   She's Talking a Lot
   Hemiparesis
   Unconscious
   Police Call
 

Joseph's CT results are not available until the 8th hospital day.

  • By the time Joseph's CT results are back, he has
    • A right ptosis and
    • A blown right pupil.
  • The CT shows multiple ring enhancing masses.
  • Joseph's ELIZA is positive for HIV.

Toxoplasmosis is the most common cause of focal neurological deficits in the HIV+ patient.

The typical presentation consists of:


Photo courtesy of Aidscicence.
  • Fever, headache, deterioration of mental status and focal neurological deficits.

In the immunocompromised patient, this represents reactivation, just like TB, rather than a primary infection.

Better tell me about toxoplasmosis.

 
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