CNS infections in HIV patients

Differential Diagnosis

• Infectious
  • Viral: routine viral causes of meningitis and encephalitits, JC virus
  • Bacterial: syphilis
  • Fungal: cryptococcosis, histoplasmosis, blastomycosis, coccidiomycosis
  • Mycobacterial: tuberculous meningitis
  • Parasitic: Toxoplasmosis
• Non-infectious
  • Primary CNS lymphoma

Investigations

• CSF sent for:
  • Cell count and differential, protein, glucose
  • Gram stain and bacterial culture
  • Cryptococcus antigen lateral flow assay
  • Acid-fast staining and tuberculosis culture
  • Fungal culture?
  • Cytology and flow cytometry
• MRI brain