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Subacute measles encephalitis with AIDS diagnosed by fine needle aspiration biopsy. A case report

T P Poon1, V Tchertkoff, H Win

  • 1Department of Pathology, New York Medical College, Metropolitan Hospital Center, New York 10029, USA.

Acta Cytologica
|June 12, 1998
PubMed
Abstract

Insights

Subacute measles encephalitis (SME) is a rare CNS complication in immunocompromised patients. Diagnosis requires brain biopsy, as antibody titers are not elevated, unlike other measles-related syndromes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Subacute measles encephalitis (SME), also known as measles inclusion body encephalitis (MIBE), is a rare central nervous system (CNS) complication of measles virus infection.
  • It predominantly affects young individuals with compromised cellular immunity, whether congenital or acquired.
  • With measles resurgence and the HIV pandemic, SME should be considered in acquired immune deficiency syndrome (AIDS) patients with unexplained CNS symptoms.

Observation:

  • A 2-year-old, HIV-positive male presented with refractory seizures.
  • Neuroimaging revealed a hypodense lesion in the right parietotemporal cortex.
  • Brain biopsy showed characteristic eosinophilic intranuclear inclusions and viral nucleocapsids on electron microscopy.

Findings:

  • The patient's presentation and biopsy results confirmed measles inclusion body encephalitis (MIBE).
  • Unlike acute measles encephalitis (AME) and subacute sclerosing panencephalitis (SSPE), SME does not typically show elevated serum or cerebrospinal fluid (CSF) measles antibody titers.
  • Fine needle aspiration biopsy (FNAB) proved essential for definitive diagnosis.

Implications:

  • This case highlights the importance of considering SME in the differential diagnosis of CNS disorders in immunocompromised individuals, particularly those with HIV.
  • Diagnostic strategies for SME must account for the absence of elevated antibody titers.
  • FNAB is a critical diagnostic tool for confirming SME when serological tests are inconclusive.

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