We present a 16-year-old boy, who had presented to us with catatonic features of
mutism, withdrawal, passive negativism, grimacing, gesturing, echopraxia, and excitement of 5 days duration while taking antiretroviral
therapy (ART) for a period of 2 years. He had history of birth
asphyxia and acquired
HIV infection from his father when the same syringe and needle was used on both of them in a medical setting where the father and son had consulted for treatment of
pyrexia of unknown origin. He was the eldest of a three children family in which the
biologic father had acquired HIV through extramarital sexual contact with HIV-infected sex workers but was unaware of his HIV positive status till our patient, the 16-year-old was admitted and treated for
pulmonary tuberculosis at 14 years of age. The boy's mother had only acquired HIV after having three children with the HIV-positive husband, thus leaving the other two children HIV negative. The
catatonia completely resolved within 2 days after the ART was withheld, and
risperidone 1 mg twice a day was prescribed. This case highlights the risks of ART and breach of universal precautions.