The patient was a 38-year-old HIV-positive male with a CD4 count of 80/ul. The patient had a 1-week history of progressi

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The Patient Was A 38 Year Old Hiv Positive Male With A Cd4 Count Of 80 Ul The Patient Had A 1 Week History Of Progressi 1 (64.9 KiB) Viewed 18 times

The patient was a 38-year-old HIV-positive male with a CD4 count of 80/ul. The patient had a 1-week history of progressively worsening headache, photophobia, lethargy, and fevers to 38.5°C. On the morning of his admission, he became confused, disoriented, and ataxic, having fallen three times. On physical examination, he was lethargic and could only answer a few questions before falling asleep. His vital signs were all within normal limits. Chest examination and radiograph were normal. He had a head computed tomogram (CT) scan which was also normal. Because of his declining mental status and history of headache and photophobia, a lumbar puncture was done. It showed 32 white blood cells perml with 88% lymphocytes and 6% monocytes, a glucose level of 22 mg/dl, and protein of 89 mg/dl. Gram stain of his cerebrospinal fluid (CSF) did not reveal any bacteria. The organism was revealed by mixing India ink with the CSF and observing in a microscope. In Addition to identifying this infectious disease and the infectious agent, ANSWER THE FOLLOWING QUESTIONS: 1. What virulence factor does this organism produce, and what is its role in the pathogenesis of this disease? 2. How did this patient become infected? 3. What would be suitable therapy for this patient and how should he be managed to prevent future infections with this organism? 4. What other organisms are frequently seen causing central nervous system infections in this patient population? Also include your interpretation of relevant history and clinical/lab findings!