Case Presentation: A 28-year-old female from Mexico with AIDS and prior Mycobacterium bovis (M. bovis) infection treated with rifampin, isoniazid, ethambutol (RIE), complicated by lumbar osteomyelitis due to suspected medication non-adherence, presented with acute onset headache and photophobia. On admission, CD4 T-cell count was 28/μL and HIV viral load was 75,200 copies/mL. Cerebral spinal fluid [...]