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Sexually Transmitted Infections 2007;83:85-86; doi:10.1136/sti.2006.020222
Copyright © 2007 by the BMJ Publishing Group Ltd.

CASE REPORT

Coma as a presenting symptom of primary HIV infection

A Umgelter, W Huber, R M Schmid and W Reindl

II Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, München, Germany

Correspondence to:
Correspondence to:
Dr A Umgelter
II Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität, Ismaningerstr 22, 81664 München, Germany; andreas.umgelter{at}lrz.tu-muenchen.de

Primary HIV infection (PHI) is symptomatic in 50–90% of patients. The diagnosis, however, is seldom made at first presentation. This is probably because of the multifaceted and unspecific manifestations, the omission to perform adequate diagnostic testing and the failure to assess risks for PHI. Meningoencephalitis has been described as a fairly common presenting condition in PHI, with nuchal rigidity, fatigue, photophobia and headache; therefore, PHI should be considered in the differential diagnosis of aseptic meningitis. We present the case of a man with acute coma and a presumptive diagnosis of viral encephalitis in whom serological testing showed HIV encephalitis during PHI.

Abbreviations: CSF, cerebrospinal fluid; PHI, primary HIV infection


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