A patient presents to a primary care provider reporting fever, headache, nuchal rigidity, and decreased consciousness. History includes a previously treated sinusitis. Which medical diagnosis is best supported by this assessment data?

Choice A reason: Dry mouth is a relatively minor side effect of statin medications and is generally not a cause for significant concern. While it can be uncomfortable and may affect oral health if persistent, it does not typically indicate a serious underlying condition.

Choice B reason: Diarrhea can be an inconvenient and uncomfortable side effect of statins, but it is not usually considered dangerous. It is important to manage it to prevent dehydration and electrolyte imbalances, but it is not as concerning as some other side effects.

Choice C reason: Muscle pain, also known as myalgia, is the most concerning side effect of statin medications like simvastatin. In rare cases, muscle pain can progress to a more serious condition called rhabdomyolysis, where muscle tissue breaks down rapidly, releasing a protein called myoglobin into the bloodstream. This can lead to kidney damage and, in severe cases, kidney failure. Therefore, any new or unexplained muscle pain should be promptly reported to a healthcare provider for evaluation.

Choice D reason: Headache is a common and generally mild side effect of many medications, including statins. While it can be bothersome, it is not typically indicative of a serious problem and is not considered as concerning as muscle pain related to statin use.

Choice A reason: Nonadherence to the antiviral regimen could lead to a resurgence of HIV symptoms and a higher viral load, but it is not typically associated with the symptoms of increased hunger, thirst, and frequent urination described by the patient.

Choice B reason: Pancreatic infiltration by HIV is a rare complication and would not be the first suspicion in this scenario. While HIV can affect multiple organs, the symptoms described are more suggestive of metabolic issues rather than direct infiltration of the pancreas.

Choice C reason: An allergic reaction to the medication would more likely present with symptoms such as rash, itching, swelling, or difficulty breathing rather than the metabolic symptoms described. Allergic reactions typically do not cause increased hunger, thirst, or frequent urination.

Choice D reason: Hyperglycemia (high blood sugar levels) is the most likely cause of the symptoms described. Protease inhibitors can lead to metabolic side effects, including insulin resistance and hyperglycemia. Symptoms of hyperglycemia include increased hunger (polyphagia), increased thirst (polydipsia), and frequent urination (polyuria). These findings are consistent with the patient's complaints and should be investigated further to manage the side effects of the medication.