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[Cytomegalovirus encephalitis in immunologically normal adults]
Rinsho Shinkeigaku = Clinical Neurology
|February 1, 1990
Summary
Cytomegalovirus (CMV) encephalitis is rare in healthy adults. Adenine arabinoside (ara-A) showed promise in one case, while acyclovir (Acv) was ineffective in another fatal case.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Cytomegalovirus (CMV) encephalitis is a rare condition, particularly in immunocompetent adults.
- This report details two distinct cases to further understand its clinical presentation and treatment outcomes.
Observation:
- Case 1: A 53-year-old male presented with acute headache, fever, and altered consciousness. Cerebrospinal fluid (CSF) analysis showed elevated cells and protein. Treatment with adenine arabinoside (ara-A) led to complete recovery.
- Case 2: A 78-year-old female experienced similar symptoms, with significantly higher CSF abnormalities and evidence of intrathecal CMV antibody production. Despite acyclovir (Acv) treatment, her condition deteriorated, leading to a fatal outcome.
Findings:
- CMV encephalitis in normal adults is uncommon, with limited reported cases.
- Treatment responses varied significantly between the two cases, highlighting potential differences in disease course or therapeutic efficacy.
- Adenine arabinoside (ara-A) may be a viable treatment option for acute encephalitis unresponsive to acyclovir (Acv).
Implications:
- These findings suggest that prompt and appropriate antiviral therapy is crucial for managing CMV encephalitis in immunocompetent individuals.
- Further research is warranted to elucidate the mechanisms underlying CMV encephalitis and to establish optimal treatment guidelines.
- Clinicians should consider CMV encephalitis in the differential diagnosis of acute encephalitis, even in immunocompetent patients, and consider ara-A when Acv is ineffective.