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Published on: July 6, 2013
[Cytomegalovirus myelitis in immunocompetent adult]
N Ben Abdelhafidh1, R Battikh, J Laabidi
1Service de médecine interne, hôpital militaire de Tunis, 1008 Mont-fleury Tunis, Tunisie.
Insights
Cytomegalovirus (CMV) infection can cause acute myelitis in immunocompetent individuals, leading to neurological symptoms. Early diagnosis and ganciclovir treatment offer partial recovery, highlighting the importance of prompt intervention for CMV-associated myelitis.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Cytomegalovirus (CMV) infection is highly prevalent, typically asymptomatic in immunocompetent individuals.
- However, CMV can manifest as serious neurological syndromes, including encephalitis and myelitis.
Observation:
- A case of a 64-year-old immunocompetent woman presented with acute limb weakness, paresthesias, and urinary retention.
- Spinal MRI revealed enhancement from cervical to lumbar regions, consistent with myelitis.
Findings:
- Diagnosis of CMV-associated myelitis was confirmed by positive CMV serology.
- Treatment with ganciclovir resulted in partial improvement over five months.
Implications:
- CMV acute myelitis in immunocompetent patients is rare, with pathogenesis likely immune-mediated.
- Early diagnosis and treatment are crucial for improving prognosis in CMV myelitis.
Introduction:
Cytomegalovirus (CMV) infection occurs in 40 to 100% of general population. It is often asymptomatic in immunocompetent subject but may induce neurological syndromes such as encephalitis and myelitis.
Case Record:
We reported a case of a 64-years-old woman immunocompetent, with acute proximal upper and lower limb weakness, paresthesias and two episodes of urinary retention. MRI of the spine showed abnormal enhancement from cervical to lumbar spine indicative for myelitis. Diagnosis of CMV associated myelitis was confirmed by a positive CMV serology. Administration of ganciclovir was followed by a partial improvement in five months.
Discussion:
Few cases of CMV acute myelitis in immunocompetent patients have been reported in the literature. The pathogenesis is not well known, however, immune-mediated central nervous system damage may be attributed to the pathogenesis of the disease. Early diagnosis and treatment improves the prognosis.
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