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Cytomegalovirus ventriculoencephalitis in AIDS patients
A Salazar1, D Podzamczer, R Reñe
1Infectious Disease Service, University of Barcelona, Spain.
Scandinavian Journal of Infectious Diseases
|January 1, 1995
Summary
Cytomegalovirus ventriculoencephalitis (CMV-VE) in AIDS patients presents with neurological decline. Ganciclovir therapy showed potential benefit in one case, highlighting the need for early diagnosis and treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Cytomegalovirus (CMV) is an opportunistic pathogen frequently encountered in individuals with advanced HIV infection.
- CMV ventriculoencephalitis (CMV-VE) is a severe complication affecting the central nervous system in immunocompromised patients.
- Diagnosis and effective treatment strategies for CMV-VE remain challenging.
Observation:
- Four autopsy-proven cases of CMV-VE in patients with prior AIDS-defining conditions are presented.
- Clinical presentation included altered neurological status, CMV retinitis, and CMV viremia.
- Cerebrospinal fluid (CSF) analysis revealed elevated protein and hypoglycorachia.
Findings:
- Magnetic resonance imaging (MRI) detected periventricular enhancement in 2/3 patients, while computed tomography (CT) showed it in only 1/5.
- Autopsy confirmed periventriculitis with ependymal necrosis and CMV intranuclear inclusion bodies in all fatal cases.
- One patient demonstrated significant clinical and radiological improvement with ganciclovir therapy.
Implications:
- CMV-VE should be suspected in HIV-infected patients with neurological decline, CMV viremia/retinitis, and MRI-detected ventriculitis.
- Ganciclovir may offer therapeutic benefit, although improved treatments are needed.
- Early diagnosis and prompt treatment are crucial for managing CMV-VE in immunocompromised individuals.