The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.
A 50-year-old man with a history of AIDS presents to the emergency department (ED) after a fall. He states that he has been experiencing progressive right leg weakness that began approximately 2 weeks ago. Initially, he only noticed difficulty getting up and down the stairs of his home; however, it has progressed to difficulty ambulating on level ground. He also complains of burning pain, cramps, and paresthesia in his left leg, which began around the same time.
Although the patient has AIDS, there is no history of major opportunistic infections or hospitalizations. The patient stopped taking his antiretroviral regimen 6 months ago. One month before presentation, he developed a painful vesicular rash extending from his right chest wall to his back and corresponding to the T2-3 dermatomes. He did not seek medical attention at that time, and the rash eventually resolved without specific treatment. He reports that he began noticing leg weakness approximately 1 week after the resolution of the rash. The patient has no known drug allergies.
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Cite this: Maribel Munoz. A 50-Year-Old Patient With AIDS and Leg Weakness - Medscape - Nov 16, 2016.