The 3 main causes of headache in an HIV hospice are curable diseases: CRYPTOCOCCOSIS,
TOXOPLASMOSIS & CEREBRAL TB. We have to exclude these 3 diseases before
diagnosing other incurable causes of headache ( LYMPHOMA, CMV...)
Be alert if:
- Former CRYPTO or former TOXO patient...
Headache is often the first sign of relapse.
- No improvement with use of common pain killer
- Other neuro signs associated (convulsion, paralysis, loss
of visual acuity...)
"Show me where you have pain"
Some other indicators:
- If also has eye pain... CRYPTO,
CMV must be ruled out first (see 19-§1-Symmetrical Neuro
- If chronic recurrent fever, loss of weight...
CEREBRAL TB more likely (see 31-Tuberculosis Protocol)
- If confused or sleepy it is "PROBABLY NOT" CRYPTO
- If acute+++, infectious signs+++, stiff neck+++, "normal
meningitis" is also of course possible! (See 19-§1-Symmetrical Neuro
- Any history of migraines, cluster headaches, etc suggests
these possible diagnoses... (Nothing specific for HIV patients)