A 33 year old Indian man, a truck driver in Mumbai, who was seropositive for human HIV and not on antiretroviral therapy, presented with a one month history of intermittent fever with sweating, gradually progressive headache, vomiting, and watery diarrhoea. He had lost 9 kg of weight in the past one month. He had smoked cigarettes for 15 years and had multiple unprotected sexual exposure in the past. He denied having had any significant illness.

On physical examination, he was emaciated, febrile, and behaving abnormally. He was irritable and restless. He was unkempt and appeared withdrawn socially with a general loss of interest. Sometimes he would answer relevantly and at other times he would become silent with a vacant stare as if unaware of his surroundings. Waxing and waning of alertness and attention deficits progressed to deeper levels of drowsiness during the hospital stay. He was anaemic with mobile, non-tender enlarged lymph nodes . . . [Full text of this article]