[Lesions of the conus medullaris and the cauda equina caused by cytomegalovirus in HIV infection. 7 cases].
OBJECTIVE
Neurologic infections caused by cytomegalovirus are common in patients with acquired immunodeficiency syndrome (AIDS). The prognosis is particularly severe when the infection is localized in the conus medullaris and/or the cauda equina.


METHODS
Among the 861 patients with AIDS treated in our unit from 1991 to 1993, 7 cases involving cytomegalovirus infection of the conus medullaris and/or the cauda equina were studied retrospectively. RESULTS OF THE CASE REPORTS: Clinical manifestations were nearly always the same: low back pain, motor deficiency in the lower limbs progressing to flaccid paraplegia and sphincter failure. The cerebrospinal fluid contained a high cell count with unaltered polynuclears and increased protein levels. In 6/7 patients virus cultures and search for the viral genome in the cerebrospinal fluid were positive. The clinical course was favourable in 6 patients after 3 weeks treatment with ganciclovir and/or foscarnet. Virology tests became negative in three-fourths of the patients. Nevertheless, relapse occurred after 4.2 weeks despite long-term therapy.


CONCLUSIONS
The severe clinical course of this disease and the gravity of constantly fatal relapse requires highly adapted treatment and overall health care.
Jacomet
C
C
Service des Maladies infectieuses et tropicales, Hôpital Rothschild, Paris.
Lebrette
M G
MG
el Amrani
M
M
Monfort
L
L
Gozlan
J
J
Girard
P M
PM
Rozenbaum
W
W
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000821:virology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D002420:Cauda Equina / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000188:drug therapy / Q000209:etiology / Q000821:virology*; D012189:Retrospective Studies; D013126:Spinal Nerve Roots / Q000821:virology*
D017245:Foscarnet; D015774:Ganciclovir
Atteintes du cône terminal et de la queue de cheval dues au cytomégalovirus au cours de l'infection à VIH. 7 observations.