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Cytomegalovirus encephalitis associated with episodic neurologic deficits and OKT-8+ pleocytosis
Abstract:
After 3 days of symptoms suggesting a viral illness, a 35-year-old man experienced three episodes of aphasia, right-sided sensory symptoms, and bifrontal headache. Each lasted several hours. CSF examination revealed a moderate lymphocytosis consisting of 80% OKT-8+ cells. Serum anti-cytomegalovirus (anti-CMV) antibody titer was elevated at 1:1,024 and subsequently fell to 1:64. Episodic symptoms recurred 5 months later, at which time the anti-CMV titer peaked at 1:8,192. A trial of inhaled oxygen aborted two episodes after several minutes each.
Insights
A man with viral illness symptoms experienced recurrent aphasia and headache. Elevated cytomegalovirus antibodies correlated with symptom recurrence, suggesting a link between cytomegalovirus infection and neurological episodes.
Area of Science:
- Neurology
- Virology
- Immunology
Background:
- Viral illnesses can present with diverse neurological manifestations.
- Cytomegalovirus (CMV) is a common virus with potential for opportunistic infections.
Observation:
- A 35-year-old man presented with aphasia, sensory symptoms, and headache after a viral illness.
- Cerebrospinal fluid (CSF) showed lymphocytosis with a high percentage of OKT-8+ cells.
- Serum anti-cytomegalovirus (anti-CMV) antibody titers were significantly elevated and fluctuated.
Findings:
- Elevated anti-CMV antibody titers correlated with the recurrence of neurological episodes.
- The patient experienced multiple episodes of aphasia, sensory disturbances, and headache.
- Inhaled oxygen therapy provided temporary relief for some episodes.
Implications:
- This case suggests a potential association between cytomegalovirus infection and episodic neurological dysfunction.
- Further research is warranted to understand the mechanisms linking CMV to these neurological symptoms.
- This case highlights the importance of considering viral etiologies, including CMV, in patients with unexplained neurological events.