An HIV-infected patient may develop an acute psychosis. It is important to identify the cause if possible in order to adequately manage the patient.
Differential diagnosis of psychosis in an HIV-infected patient:
(1) pre-existing psychotic disorder
(2) psychotic depression
(3) substance abuse
(4) metabolic encephalopathy
(5) HIV encephalopathy
(6) other infection of the central nervous system
(7) adverse reaction to a therapeutic drug
(8) central nervous system tumor
The evaluation may involve:
(1) review of past medical history
(2) interviews of family, friends and acquaintances about the patient's recent status
(3) review of anti-retroviral therapy
(4) review of other medications
(5) blood analysis
(6) drug screening
(7) brain imaging studies
(8) CSF fluid analysis and culture
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Purpose: To consider possible explanations for acute psychosis in an HIV-positive patient.
Specialty: Psychiatry
Objective: differential diagnosis and mimics, red flags, psychological response
ICD-10: F05, F10, F23,
