Cerebrospinal fluid manifestations of the neurologic complications of human immunodeficiency virus infection.
Cerebrospinal fluid (CSF) cytology, white blood cell (WBC) count and protein were evaluated in 32 human immunodeficiency virus (HIV)-infected patients with the acquired immune deficiency syndrome (AIDS) or an AIDS-related complex who manifested a variety of neurologic symptoms. Of 17 patients with AIDS-related encephalitis (ARE), 13 had hypocellular CSFs; elevated WBCs and pleocytosis were noted in 4, multinucleated giant cells in 2 and elevated CSF protein was found in 4 of 8 specimens tested. Three patients with central nervous system (CNS) toxoplasmosis had unremarkable CSF cytology findings, but all had elevated CSF proteins. In five patients with cryptococcal meningitis, cytologic examinations demonstrated organisms in four and elevated proteins in three. Of five patients with primary CNS lymphomas, one had cytology positive for large cell lymphoma; two showed suspicious cells and two manifested "atypical lymphocytes." Elevated CSF protein was present in four. Other conditions observed included progressive multifocal leukoencephalopathy, tubercular meningitis and cytomegaloviral (CMV) meningitis or encephalitis. Twenty-five percent of patients with ARE manifested pleocytosis with multinucleated giant cells; pleocytosis with CMV inclusions was noted in a CMV viral radiculitis. The CSF cytologic examination in HIV-infected patients with neurologic complications seems helpful in diagnosing cryptococcal meningitis and lymphoma, but less so for diagnosing toxoplasmosis.
Katz
R L
RL
Department of Pathology, University of Texas M. D. Anderson Hospital and Tumor Institute, Houston 77030.
Alappattu
C
C
Glass
J P
JP
Bruner
J M
JM
D000386:AIDS-Related Complex / Q000134:cerebrospinal fluid* / Q000473:pathology; D000163:Acquired Immunodeficiency Syndrome / Q000134:cerebrospinal fluid* / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000473:pathology; D003453:Cryptococcosis / Q000134:cerebrospinal fluid; D003586:Cytomegalovirus Infections / Q000134:cerebrospinal fluid; D004660:Encephalitis / Q000134:cerebrospinal fluid* / Q000473:pathology; D006801:Humans; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000134:cerebrospinal fluid; D027383:Papillomaviridae; D027382:Polyomaviridae; D014123:Toxoplasmosis / Q000134:cerebrospinal fluid; D014412:Tumor Virus Infections / Q000134:cerebrospinal fluid