Fast Five Quiz: Schizophrenia Differential Diagnosis

Stephen Soreff, MD


August 11, 2020

HIV penetrates the blood-brain barrier early in the course of the infection and thus can cause a number of mental status changes, particularly dementia or other neuropsychological impairment. In addition, patients with uncontrolled HIV infection that progresses to AIDS are at risk for opportunistic infections, such as neurosyphilis, toxoplasmosis, cryptococcal meningitis, progressive multifocal leukoencephalopathy, cytomegalovirus encephalopathy, and tuberculous meningitis, all of which can lead to mental status changes.

Persons infected with HIV are also at risk for primary central nervous system lymphoma. Many medications used to treat HIV may cause mental status changes. Finally, persons infected with HIV are at risk for nutritional deficiencies that also contribute to mental status changes.

Gonorrhea, chlamydia, and cellulitis are not associated with mental status changes.

A patient presenting with psychotic features requires a comprehensive psychiatric and medical history along with a complete mental status examination. Laboratory and radiologic studies are also needed in some patients to assist in the differential diagnosis.

Learn more about schizophrenia differential diagnosis.


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