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Arch Ophthalmol. 1998;116:953-954.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 31-year-old male-to-female transsexual prostitute, a recent immigrant from Mexico, came to the emergency department disoriented and with an elevated temperature. Medical history was notable for recent purified protein derivative positivity on skin testing. A chest x-ray film at examination showed fine miliary opacities in all lung fields (Figure 1). A computed tomographic scan of the head revealed prominent meningeal vascularity and multiple supratentorial and infratentorial enhancing lesions (Figure 2). A lumbar puncture specimen contained 618 white blood cells, of which 0.84 were neutrophils; 0.12, monocytes; and 0.04, lymphocytes. The diagnosis was presumed Mycobacterium tuberculosis infection and the patient was admitted for therapy with 4 drugs that included isoniazide, rifampin, ethambutol hydrochloride, and pyrizinimide. On the second hospital day, the ophthalmology service was asked to see the patient because of blurred vision of 2 months' duration. The patient was lethargic, with a best-corrected visual acuity of . . . [Full Text of this Article]

Corresponding author: Emmett T. Cunningham, Jr, MD, PhD, The Francis I. Proctor Foundation, University of California, San Francisco, School of Medicine, San Francisco, CA 94143-0944 (e-mail: emmett@itsa.ucsf.edu).

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