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Adenovirus encephalitis and widespread ependymitis in a child with AIDS
K H Anders1, C S Park, M E Cornford
1Department of Pathology (Neuropathology), UCLA Medical Center.
Insights
A pediatric AIDS patient developed adenovirus encephalitis, confirmed by brain autopsy showing characteristic viral inclusions and DNA. This case highlights a rare but severe complication in immunocompromised children.
Area of Science:
- Neurology
- Virology
- Pediatrics
Background:
- Acquired immunodeficiency syndrome (AIDS) can lead to opportunistic infections affecting the central nervous system.
- Encephalitis in pediatric patients with AIDS presents a diagnostic and therapeutic challenge.
Observation:
- A 4-year-old child with AIDS presented with encephalitis.
- Adenovirus was isolated from cerebrospinal fluid.
- Autopsy revealed significant brain pathology, including ependymal sloughing, gliosis, and edema.
Findings:
- Microscopic examination of brain tissue showed cells with intranuclear inclusions typical of adenovirus.
- In situ hybridization confirmed the presence of adenovirus DNA within these cells.
- Morphological evidence confirmed adenovirus encephalitis.
Implications:
- This case demonstrates a morphologically proven instance of adenovirus encephalitis in a pediatric AIDS patient.
- Highlights the potential for severe neurological complications from adenovirus in immunocompromised children.
- Underscores the importance of considering viral etiologies in encephalitis among pediatric AIDS patients.
Abstract:
A 4-year-old child with AIDS developed encephalitis 2 months prior to death. Adenovirus was cultured from the cerebrospinal fluid. At autopsy, sections of the brain revealed complete sloughing of the intracranial ependyma, with marked gliosis and edema of the periventricular white matter. Cells with large, dark, smudgy intranuclear inclusions, consistent with adenovirus inclusions, were also seen in subependymal locations. In situ hybridization studies confirmed the presence of adenovirus DNA in these cells. This represents a case of morphologically proven adenovirus encephalitis in a pediatric AIDS patient.