A 49-year-old man had acute-onset dizziness, vomiting and diplopia. He had taken treatment for HIV infection since 2017, with a CD4 count over 300×106/L (430–1690) and suppressed HIV viral load. His blood pressure was 170/110 mm Hg on presentation though without history of hypertension. On examination, there were cerebellar signs, including bilateral horizontal gaze-evoked nystagmus, dysdiadochokinesia, dysmetria and an ataxic gait. An uncontrasted CT scan of the head identified bilateral cerebellar and brainstem (midbrain, pontine and medullary) haemorrhages, but CT angiogram of the cerebral and neck vessels was normal. We initially diagnosed a hypertensive-related intracranial haemorrhage and admitted him to optimise vascular risk factors and for rehabilitation. Over the next 48 hours, he …

中文翻译：

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表现为多发性脑出血的神经李斯特菌病

一名 49 岁男子急性发作头晕、呕吐和复视。自 2017 年起接受 HIV 感染治疗，CD4 计数超过 300×106/L (430-1690)，并抑制 HIV 病毒载量。尽管没有高血压病史，他的血压为 170/110 mm Hg。检查时，有小脑体征，包括双侧水平凝视诱发的眼球震颤、运动障碍、视力障碍和共济失调步态。头部非对比 CT 扫描发现双侧小脑和脑干（中脑、脑桥和髓质）出血，但脑和颈部血管的 CT 血管造影正常。我们最初诊断出高血压相关的颅内出血，并让他优化血管危险因素并进行康复治疗。在接下来的 48 小时内，他...