Multiple Opportunistic Infections in a Patient with Advanced HIV Disease.

• ¹, Lagos University Teaching Hospital Idi-Araba ,

Opportunistic infections cause significant morbidity and mortality in patients infected with the human immunodeficiency  virus (HIV). Although pulmonary tuberculosis remains the main opportunistic  infection (OI) in people living with HIV (PLHIV), multiple OIs can occur in severely immunosuppressed PLHIV. One of the challenges in diagnosis and treatment of OIs is that they may occur concomitantly  in the same patient, and they may mimic each other, leading to clinical diagnostic  difficulties. Additionally, although all newly diagnosed PLHIV with features of acquired immune deficiency syndrome (AIDS) now undergo routine testing for life-threatening OIs, the limited  resources  available  within  the  public  HIV  programme  means  that  certain populations of patients are managed for OIs with diagnostic uncertainty. We report a case of multiple OIs (Neurocysticercosis, Pott’s disease, and central nervous system [CNS] toxoplasmosis) in a 29-year-old male, who had tested positive to HIV two years prior but did not start Antiretroviral Therapy (ART) and later presented with seizures, altered sensorium and vomiting, with a CD4 count of 9 cells/mm 3. He was treated with steroids initially to prevent worsening of his neurological symptoms before appropriate antimicrobials were instituted and later, to prevent immune reconstitution inflammatory syndrome (IRIS), ART.