Tropical spastic paraparesis-like illness occurring in a patient dually infected with HIV-1 and HTLV-II.
We describe a 34-year-old man from southern Florida with a history of intravenous drug use, dually infected with human immunodeficiency virus type 1 (HIV-1) and human T-lymphotropic virus type II (HTLV-II), who developed a myelopathy clinically indistinguishable from HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This myelopathy was characterized by spastic lower extremity weakness, distal paresthesias, sensory loss with a discrete thoracic level to pinprick, back pain, impotence, and sphincter disturbances. Nerve conduction studies revealed an associated mixed axonal and demyelinative neuropathy. Despite a lack of response to 10 months of zidovudine therapy, the myeloneuropathy improved dramatically 2 years after its onset in the absence of any therapeutic intervention.
Berger
J R
JR
Department of Neurology, University of Miami School of Medicine, FL 33136.
Svenningsson
A
A
Raffanti
S
S
Resnick
L
L
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D007172:Erectile Dysfunction / Q000209:etiology; D005684:Gait; D015497:HIV-1; D015491:HTLV-II Infections / Q000150:complications*; D006801:Humans; D008297:Male; D015493:Paraparesis, Tropical Spastic / Q000150:complications* / Q000503:physiopathology; D012677:Sensation