Cytomegalovirus (CMV) Polyradiculopathy: An Important "AIDS-Defining" Illness Complication

Area of Science:

• Neurology
• Infectious Diseases
• Virology

Background:

• Cytomegalovirus (CMV) infections are common in patients with advanced HIV/AIDS.
• CMV can affect the central and peripheral nervous systems.
• CMV polyradiculopathy is a rare but serious complication.

Observation:

• A 43-year-old male with HIV/AIDS presented with altered mentation, CMV encephalitis, and retinitis.
• Cerebrospinal fluid analysis confirmed CMV infection.
• The patient developed urinary retention, lower extremity weakness, and sensory disturbances.

Findings:

• Electromyography revealed lumbosacral root dysfunction consistent with CMV polyradiculopathy.
• Antiviral therapy (ganciclovir, foscarnet) and HAART were initiated.
• Despite treatment, significant improvement in polyradiculopathy symptoms was not observed after 180 days.

Implications:

• This case underscores the limited data and treatment guidelines for CMV polyradiculopathy.
• Prolonged treatment may be necessary for CMV polyradiculopathy.
• Recovery of neurological function in CMV polyradiculopathy can be challenging.