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Coma as a presenting symptom of primary HIV infection

A Umgelter1, W Huber, R M Schmid

  • 1II Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität, Ismaningerstr 22, 81664 München, Germany. andreas.umgelter@lrz.tu-muenchen.de

Sexually Transmitted Infections
|April 17, 2007
PubMed

Insights

Primary HIV infection (PHI) is often missed due to vague symptoms. Early diagnosis is crucial, as PHI can present as neurological conditions like encephalitis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Primary HIV infection (PHI) presents with diverse, non-specific symptoms in 50-90% of cases.
  • Diagnosis of PHI is frequently delayed due to unspecific manifestations and inadequate testing.
  • PHI should be considered in the differential diagnosis of aseptic meningitis and encephalitis.

Observation:

  • A case of acute coma with a presumptive diagnosis of viral encephalitis is presented.
  • The patient exhibited symptoms suggestive of meningoencephalitis, a known presentation of PHI.
  • Diagnostic challenges included the unspecific nature of symptoms and initial misdiagnosis.

Findings:

  • Serological testing confirmed HIV encephalitis during the acute phase of primary HIV infection.
  • The patient's coma was attributed to HIV encephalitis, highlighting a severe neurological manifestation of PHI.
  • This case underscores the importance of considering PHI in patients with unexplained neurological symptoms.

Implications:

  • Increased awareness of PHI's neurological presentations can improve early diagnosis rates.
  • Implementing routine HIV testing in patients with aseptic meningitis or encephalitis is recommended.
  • Timely diagnosis and treatment of PHI are critical to prevent severe complications and disease progression.

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