Seeing Snakes: An HIV Patient with Visual Hallucinations

A 45-year-old African American man with HIV presented to an outside hospital two months prior to the current hospitalization with unsteady gait and left hemiparesis. Magnetic resonance imaging (MRI) of the brain demonstrated a left postcentral gyrus and two left temporal lobe enhancing lesions. Mycobacterium tuberculosis polymerase chain reaction was negative, however, he had a history of exposure to a family member with tuberculosis and was consequently started on rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE) as well as antiretroviral therapy (ART).