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


To read more or access our algorithms and calculators, please log in or register.