Haemorrhagic conversion of infectious myelitis in an immunocompromised patient.

A 28-year-old man recently diagnosed with HIV (CD4 19 cells/mm, viral load 3.6 million copies/mL, not on highly active antiretroviral therapy on initial diagnosis at outside hospital), disseminated histoplasmosis, shingles and syphilis presented with paraplegia developing over 3 days. Spine MRI demonstrated a longitudinally extensive cord lesion extending from C3 to the tip of the conus.