CMV and HSV-2 myeloradiculitis in an HIV infected patient

While CMV myeloradiculitis is a known complication in AIDS patients with severe immunosuppression, HSV-2 necrotizing myeloradiculitis is rare and often associated with disabling a fatal outcome. We hereby describe a 46 year-old HIV infected patient with profound and sustained immunosuppression who p...

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Bibliographic Details
Published in:Revista do Instituto de Medicina Tropical de São Paulo
Main Authors: Adriana Pinto, Edwiges Santos, Danusa F. Correa, Rodrigo Escada, Carla de Mello Vorsatz, Sandra Wagner Cardoso, Marco A. Lima
Format: Article in Journal/Newspaper
Language:English
Published: Universidade de São Paulo (USP) 2011
Subjects:
Cytomegalovirus
Herpes simplex 2
HIV
Myelitis
Foscarnet
Ganciclovir
Arctic medicine. Tropical medicine
RC955-962
Infectious and parasitic diseases
RC109-216
Arctic
Online Access:https://doi.org/10.1590/S0036-46652011000300010
https://doaj.org/article/c154b993c22d4bbdb89e8538c6ce38a6
Description
Summary:While CMV myeloradiculitis is a known complication in AIDS patients with severe immunosuppression, HSV-2 necrotizing myeloradiculitis is rare and often associated with disabling a fatal outcome. We hereby describe a 46 year-old HIV infected patient with profound and sustained immunosuppression who presented with an acute ascending paraparesis and urinary retention. Lumbar spine MRI showed contrast enhancement at the conus medullaris and cauda equine, and both CMV and HSV-2 CSF PCR were positive. Despite treatment, the patient died 20 days later. We review the main diagnostic and therapeutic aspects of herpes virus associated myeloradiculitis and discuss the approach in similar cases.

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