A 28-Year-Old Man Comes to the Office Due to Abnormal

A 28-year-old man comes to the office due to abnormal movements of his arm and face over the last week.  The patient has had 1- to 2-minute episodes of jerking and twitching of the left arm and left side of the face.  He has also had daily headaches for a few weeks that are often associated with nausea.  The patient was recently diagnosed with HIV and started antiretroviral therapy 2 months ago.  At that time, his CD4 count was 46/mm³.  He has a history of intravenous heroin use but recently started a methadone program.  Temperature is 37.8 C (100 F) , blood pressure is 124/82 mm Hg, and pulse is 76/min.  Cardiopulmonary examination is normal with no murmur.  Left arm motor strength is 4/5, and deep tendon reflexes are 3+.  An MRI of the brain reveals several ring-enhancing lesions at the gray-white matter junction and basal ganglia.  Which of the following is the most appropriate treatment for this patient?

A) Albendazole
B) Amphotericin B and flucytosine
C) Clarithromycin and ethambutol
D) Ganciclovir
E) Stereotactic brain biopsy
F) Sulfadiazine and pyrimethamine
G) Vancomycin and ceftriaxone

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free