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Old 08-15-2012
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Neuro HIV Patient with Altered Mental Status!

A 25-yr old HIV-postive male presents to the office with an altered mental status. He is disoriented, lethargic, and has loss of recent memory. These symptoms have been present for the last month. His current medication include antiretroviral therapy, TMP-SMX and azithromycin. His temp 99.8F, pulse 78/min BP 130/80 and Respiration 16/min. The neurological examination is non-focal. His CD4 count is 40/microL and viral load is 25,000 copies/ml by PCR. MRI scan reveals a solitary, irregular, weakly ring-enhancing mass in the periventricular area. The serology for toxoplasma is positive. PCR of CSF shows EBV DNA. what is the most likely diagnosis

A. Cerebral toxoplasmosis
B. Primary CNS Lymphoma
C. Progressive multifocal leukoencephalopathy
D. AIDS dementia Complex
E. Bacterial abscess

Please Explain.

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Old 08-15-2012
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Its primary cns lymphoma caused by ebv. he is on prophylaxis so not toxoplasma. serology is positive in many.
Pml ans aids dementia not ring enhancing mass lesions
Abcess needs fever focal findings.
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The above post was thanked by:
step_enhancer (08-15-2012), Taayseer (09-06-2014)



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