A 28-year-old nurse presented to the emergency department complaining of headaches and confusion. Her headaches have developed over the past 3 weeks and have become progressively more severe. The headaches are now persistent and diffuse. Her relative who accompanies her says that she has lost 10 kg in weight over 6 months and has recently become increasingly confused. Her speech is slurred. While in the emergency department she has a generalized tonic-clonic convulsion. Physical Examination She is thin and weighs 55 kg.
Temperature - 38.5°C. Oral candidiasis is present No lymphadenopathy. Examination of her cardiovascular, respiratory, and gastrointestinal systems is normal. Neurological examination prior to her convulsion showed her to be disoriented in TPP. There were no focal neurological signs. Funduscopy shows bilateral papilledema. A computed tomography scan of the brain is…
