1.
Proc (Bayl Univ Med Cent)
; 33(4): 614-615, 2020 Jun 25.
Article
in English
| MEDLINE
| ID: mdl-33100544
ABSTRACT
We report a 50-year-old man with a possible stroke 3 months earlier, recurrent shingles outbreaks, and male-who-has-sex-with-men status who presented to the emergency department with worsening confusion, lower-extremity weakness, gait imbalance, and incontinence. Given his clinically immunocompromised state, the patient was started on intravenous acyclovir. A human immunodeficiency virus (HIV) test returned positive, magnetic resonance imaging of the brain showed a ring-enhancing lesion, and lumbar puncture was positive for varicella-zoster virus. Eventual brain biopsy of the ring-enhancing lesion confirmed vasculitis. This case highlights the broad differential of a ring-enhancing lesion and the importance of early HIV screening.