A rare case of HIV encephalopathy presenting with an isolated cerebellar syndrome

Cerebellar dysfunction is a well-recognised but an infrequent complication of human immunodeficiency virus (HIV) infection. We present the case of a 44-year-old man living with HIV who presented with subacute cerebellar dysfunction and in whom a thorough diagnostic work-up did not identify any opportunistic infections. Cerebrospinal fluid (CSF) analysis showed a high HIV viral load of 1160 copies/ml and magnetic resonance imaging (MRI) showed multiple high signal abnormalities, disproportionately affecting the posterior fossa especially the cerebellum. This is a rare case of HIV encephalopathy presenting with an isolated cerebellar syndrome and highlights the importance of considering HIV as the aetiology in this clinical scenario.