A 40-year-old South African man presented with progressive difficulty walking, bilateral leg weakness, and balance problems. He described vague cognitive symptoms and new-onset urinary incontinence. Notwithstanding a 2008 HIV diagnosis (infection date unknown), due to social issues he did not obtain medical care. There was no medical history of opportunistic infections (OIs) or other problems associated with HIV. Three months before presentation, however, he had stopped working as a home care assistant due to unsteady gait. In addition, he described a recent 30-pound weight loss. He denied headaches or neck pain. There was no relevant family history, and he took no medication.
Footnotes
↵* These authors contributed equally to this report.
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