Abstract

THE RETROVIRUS OF A THOUSAND FACES

After two decades in the neurological trenches of a busy, developing world, general hospital, one hopes to have reached a state in which, by and large, one’s adversary is usually clinically recognizable. Rising to the challenge of making a diagnosis, and, often equally important, knowing what to suggest as the wisest course of action for each individual patient, is part of the job satisfaction. So it comes as something of a shock to find yourself robbed of certain clinical impressions that you may have comfortably harboured. For this is what happens when you come face-to-face with an epidemic in which the nervous system is involved in over 90% of the patients, and in which the neurological picture has a thousand faces. I refer to HIV/AIDS. In our hospital, the daily general medical ward intake of about 30 patients now contains about 40% with HIV