[Clinical Picture] Upbeat nystagmus in an HIV-positive patient with a tuberculoma in the medulla

A 33-year-old woman, with HIV infection (CD4 count of 13 cells per μL; viral load of 1·2 × 106 copies per mL) and Mycobacterium tuberculosis diagnosed 2 months before, presented to the National Institutes of Health (Bethesda, MD, USA). On arrival, she was on a regimen of antituberculosis drugs (rifampicin 600 mg, ethambutol 1200 mg, and pyrazinamide 1500 mg orally daily), but had not begun antiretroviral therapy (ART). About the time of ART initiation (dolutegravir 50 mg and emtricitabine 200 mg plus tenofovir 300 mg orally daily), she complained of severe nausea and tests for gastrointestinal causes (oesophagogastroduodenoscopy, colonoscopy, full-body PET-CT, and celiac antibody panel [anti-gliadin IgA and IgG and anti-endomysial IgA]) were unremarkable.
Source: The Lancet Infectious Diseases - Category: Infectious Diseases Authors: Tags: Clinical Picture Source Type: research