ABSTRACT
A 40-year-old woman was brought to the emergency department by her husband who reported that her personality had changed dramatically over recent weeks. The patient denied any symptoms and wanted to leave hospital immediately. Her husband explained that she had become paranoid and was refusing to eat as she believed that he had poisoned her food. She complained of frequent headaches and had stopped going to work. She had tested positive for HIV 8 years earlier and had never adhered to anti-retroviral therapy. She took no regular medications. She worked as a traffic warden and had not travelled abroad for 4 years.
