Question

Patient with HIV and CD4 <200 who presents with subacute mental status changes, motor deficits, ataxia with multiple non-enhancing brain lesions on CT:

a) Toxoplasmosis
b) Progressive multifocal leukoencephalopathy (PML)
c) Cerebral toxocariasis
d) Cryptococcal meningitis

Answer 1

The correct answer is Progressive multifocal leukoencephalopathy (PML). PML is a rare opportunistic infection that occurs in immunocompromise.

Step-by-step explanation:

The correct answer is b) Progressive multifocal leukoencephalopathy (PML).

PML is a rare opportunistic infection that occurs in immunocompromised individuals, especially those with HIV/AIDS and a low CD4 count (<200). It is caused by the JC virus, which infects the white matter of the brain and leads to the destruction of myelin.

Patients with PML often present with subacute mental status changes, motor deficits, ataxia, and multiple non-enhancing brain lesions on imaging studies like CT or MRI. Unlike other infections like toxoplasmosis or cryptococcal meningitis, PML lesions do not enhance with contrast.