Chapter 5-6: Differential Diagnosis of Headache in Patient with HIV

Acute neurologic presentation

1. Bacterial meningitis due to Neisseria meningitidis, S pneumoniae, or Listeria monocytogenes

2. Aseptic meningitis due to HIV or syphilis (especially secondary syphilis)

3. Meningoencephalitis due to HSV-1, West Nile virus, or acute HIV infection

4. Guillain-Barré syndrome associated with HIV infection

Neurologic presentation with subacute meningitis

1. Cryptococcal meningitis

2. Coccidioidomycosis (southwestern United States)

3. Histoplasmosis and blastomycosis (Midwest)

4. TB meningitis

5. Meningovascular syphilis

Nonfocal neurologic presentation with diffuse, chronic brain involvement

1. HIV encephalopathy in advanced AIDS

2. CMV encephalitis

3. Neurosyphilis with general paresis and dementia

Mass lesions or focal demyelination

1. Toxoplasmosis (rim-enhancing mass lesions)

2. PCL (diffusely-enhancing mass lesions)

3. PML (focal areas of demyelination without enhancement or mass effect)

4. Uncommon mass lesions: tuberculoma, cryptococcoma, Nocardia brain abscess, bacterial or fungal brain abscess