Participant 2: Miss O.P, 32-year-old single seamstress admitted with recurrent fever of three months, cough, weight loss and then right sided weakness of one day. She was not a known patient with haemoglobinopathy, hypertension, or diabetes mellitus. No history of significant alcohol consumption, cigarette smoking or use of illicit drugs. She had recurrent diarrhoea for about two months with a positive history of multiple sexual partners. On admission, she had hyperpigmented skin, dehydrated, febrile to touch (temperature- 38 C), anicteric and pale (PCV 22%). There was right hemiparesis, with power of 4 in the right upper limb and 2 in the right lower limb, with chest signs of consolidation on the right side, confirmed on chest radiograph. There was hepatomegaly of 2-4cm, with a tipped spleen. Her blood pressure was 90/60 mmHg. There were hemic murmurs with tachycardia of 102bpm. Blood was sterile on culture. The random blood glucose was 76mg/dl, with normal plasma lipids profile. Aside a hyponatraemia of 131mmol/l her renal assessment was normal. A computerized tomography (CT) scan was not done for financial reasons. She had stroke care, rehydration and systematic antibiotics. A follow-up chest X-ray after antibiotics reveal underlined features suggestive of tuberculosis. Even though she had a smear-negative sputum examination, her genexpert examination was positive.
Outcome: she improved remarkably, had anti tuberculosis treatment, and was enrolled in the adult HIV services and had ART.