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Acute encephalopathy and multi-organ involvement with rhabdomyolysis during primary HIV infection

Miltiadis Douvoyiannis1, Nathan Litman

  • 1Department of Pediatrics, Division of Pediatric Infectious Diseases, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3415 Bainbridge Avenue, Rosenthal 4th Floor, Bronx, NY 10467, USA. mdouvoyi@montefiore.org

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|March 28, 2009
PubMed

Insights

Primary HIV infection can cause severe neurological and organ issues, including encephalopathy and rhabdomyolysis. Prompt consideration of primary HIV infection is crucial for unexplained symptoms in patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Primary HIV infection (PHI) is a critical stage for disease manifestation.
  • Central nervous system (CNS) complications in PHI are diverse and can be severe.
  • Rhabdomyolysis is a recognized, though less common, complication of PHI.

Observation:

  • An adolescent male presented with encephalopathy and multi-organ involvement, including rhabdomyolysis, during PHI.
  • The patient's symptoms resolved spontaneously within days.
  • Previous reports detail various CNS complications in PHI, with significant mortality and morbidity.

Findings:

  • PHI can manifest with severe neurological symptoms like encephalopathy and systemic involvement such as rhabdomyolysis.
  • While CNS complications in PHI have a high risk of poor outcomes, rhabdomyolysis cases reported have shown full recovery.
  • Steroid treatment showed limited efficacy for most CNS complications, excluding multiple sclerosis.

Implications:

  • Clinicians should consider PHI in patients presenting with unexplained neurological symptoms, rhabdomyolysis, or multi-organ dysfunction.
  • The controversial topic of early antiretroviral therapy initiation during PHI warrants further investigation.
  • Recognizing the diverse clinical spectrum of PHI is essential for timely diagnosis and management.

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