12-21-2014, 08:35 PM
You are taking care of a 49-year-old woman who was admitted to the hospital because of progressive numbness of the right arm and difficulty in seeing objects in the left visual field. She is known to be HIV positive, but has not consistently taken medications in the past. On examination she is healthy appearing, has a right homonymous hemianopia, and decreased sensory perception in her left upper extremity and face. Her CD4 count is 60 cells/mm3 and her MRI is consistent with a demyelinating lesion of the left parietooccipital area. CSF PCR for the JC virus is positive. The most appropriate treatment is
A. amphotericin B
B. cranial radiation
C. highly active antiretroviral therapy (HAART)
D. intravenous acyclovir
E. intravenous ceftriaxone
A. amphotericin B
B. cranial radiation
C. highly active antiretroviral therapy (HAART)
D. intravenous acyclovir
E. intravenous ceftriaxone