The patient is well oriented but appears lethargic and groans while holding his head. His vital signs are within normal limits. On physical examination, there is no nuchal rigidity or facial tenderness to percussion. Fundoscopic examination is normal. Auscultation and percussion of the chest is normal.
Neurologic evaluation is normal.
A complete blood count is normal. Radiographic studies, including a chest radiograph and computed tomography of the head, are normal. Assessment for HIV antibodies is positive. CSF cultures are positive for Cryptococcal neoformans on the tenth day of admission.