[Nervous system lesions due to cytomegalovirus in AIDS]

Viral infections are observed with increasing frequency in HIV patients and one of the commonest viruses is cytomegalovirus. Clinical features of cytomegalovirus (CMV) encephalitis are non specific and radiology is rarely helpful. Polymerase chain reaction in cerebrospinal fluid has been shown to be useful for diagnosis of CMV encephalitis. CMV lesions in the nervous system are subdivided into six groups: Nodular encephalitis, myeloradiculitis, isolated inclusion-bearing cells, focal parenchymal necrosis, ventriculo-encephalitis and peripheral neuropathy. Clinicopathological aspects are only subdivided into four groups: Encephalitis, myelitis, myeloradiculitis and polyneuropathy. Diagnosis of cytomegalovirus encephalitis should be considered in patients with a CD4 count less than 100 cells/mm3. Recent developments in diagnostic techniques allow early recognition and more aggressive therapeutic approaches.