A 38-year-old man is brought to the emergency department due t | Uworld | Step 2ck

A 38-year-old man is brought to the emergency department due to confusion and double vision. His family reports that the patient did not feel well for the past several days due to headaches, nausea, and vomiting. Yesterday, he became progressively confused and experienced double vision. He has a history of HIV and does not take antiretroviral therapy consistently. Temperature is 38.2 C (100.7 F), blood pressure is 122/80 mm Hg, and pulse is 90/min. On physical examination,
the patient appears lethargic and disoriented. Pupils are equal and reactive, but the left eye does
not move laterally with leftward gaze. The rest of the neurologic examination is unremarkable. Skin examination shows scattered, small, umbilicated papules with surrounding erytherna. CT scan of the head reveals mildly enlarged ventricles but no hemorrhage, infarction, or mass lesions.