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AIDS with acute cerebral infarct: a case report
Lin-Hui Wu1, Wei-Hung Chen, Li-Ming Lien
1Department of Neurology and Infectious Disease, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Abstract:
A 38 year-old male presented with an acute onset of left hemiplegia. Brain magnetic resonance imaging (MRI) revealed a bright lesion by diffusion-weighted imaging with low apparent diffusion coefficient value in the right subcortical region, a finding compatible with an acute cerebral infarct. An old infarct was also noted in the same imaging. Both enzyme-linked immunosorbent assay and Western blot method were positive for human immunodeficiency virus infection. The white blood cell count was 2930 cells / mm3, and the subpopulation study for lymphocyte revealed a decreased cluster of differentiation 4+ count of 149 cells/mm3. Studies for prothrombotic states showed decreased protein S and increased anticardiolipin antibodies. We concluded that this was a case of acquired immunodeficiency syndrome (AIDS) with acute and old cerebral infarcts. This patient might be the first reported case in Taiwan. AIDS might be related with stroke in young patients, a condition probably under-recognized in Taiwan.
Insights
This case study highlights a young man with acquired immunodeficiency syndrome (AIDS) who experienced both acute and old cerebral infarcts. The findings suggest a potential link between AIDS and stroke in younger individuals, a condition possibly underdiagnosed in Taiwan.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Acquired immunodeficiency syndrome (AIDS) is a chronic condition affecting the immune system.
- Cerebrovascular events, such as stroke, can occur in individuals with compromised immune systems.
Observation:
- A 38-year-old male presented with acute left hemiplegia.
- Brain MRI confirmed an acute cerebral infarct in the right subcortical region and an old infarct.
- Diagnostic tests revealed human immunodeficiency virus (HIV) infection with a low CD4+ T-cell count (149 cells/mm3).
Findings:
- The patient exhibited prothrombotic factors, including decreased Protein S and elevated anticardiolipin antibodies.
- The clinical presentation and diagnostic findings were consistent with AIDS-related cerebral infarcts.
- This represents a potentially novel case of stroke in an HIV-positive young adult in Taiwan.
Implications:
- The findings suggest a possible association between AIDS and stroke in younger populations.
- This case underscores the importance of considering HIV/AIDS in young patients presenting with cerebrovascular events.
- Further research is warranted to explore the mechanisms linking HIV/AIDS and stroke, particularly in under-recognized populations.
