Cytomegalovirus polyradiculopathy in HIV-infected patients.
Cytomegalovirus polyradiculopathy, a late complication of HIV infection, is characterized by lower extremity weakness, urinary retention, and sacral dysesthesias. We describe four patients (mean CD4 T-cell count = 25 cells/mm3) who developed this "infectious cauda equina syndrome." The characteristic cerebrospinal fluid (CSF) findings, notably atypical for a viral infection, included polymorphonuclear leukocytosis (mean white blood cell count = 1512 cells/mm3, 72% polymorphonuclear leukocytes), elevated protein level (mean = 370 mg/dl), and hypoglycorrhacia (mean = 28 mg/dl). Physicians who treat patients with HIV should be familiar with this syndrome because early intervention, prior to microbiologic confirmation, provides the best hope for improving neurologic function.
Meier
P A
PA
Department of Infectious Diseases, Wilford Hall Medical Center, Lackland Air Force Base, TX 78236-5300, USA.
Stephan
K T
KT
Blatt
S P
SP
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy / Q000209:etiology / Q000821:virology*; D011128:Polyradiculopathy / Q000188:drug therapy / Q000209:etiology / Q000821:virology*; D011379:Prognosis
D000998:Antiviral Agents; D015774:Ganciclovir