22nd SMS, A case
CASE SCENARIO ,,, A 55 year old man with headache andconfusion. He has a cough and a temperature of 38.2C . He doesnt complain of any other symptoms. On examination he looks thin and unwell and slightly drowsy. His mini mental test score was 8/10. There were some crackels in upper zones of the chest posteriorly. His respiratory rate was 20/min. There were no neurological sings. Two months earlier he was admitted with productive cough and acid fast bacilli in his sputum on direct smear. He had weight loss and complained of night sweating. He has a history of head injury. He smokes 15 cigarettes a day and is an alcoholic, he is homeless too. His chest x-ray showed patchy infiltration in the right upper lobe. What might be the cause of his second admission?