[Lumbosacral polyradiculomyelitis caused by herpes simplex virus (HSV) in a patient with AIDS].
To our knowledge this is the first description of lumbosacral polyradiculopathy produced by herpes simplex virus (HSV) without coinfection by cytomegalovirus (CMV) in a patient with HIV infection. The acute lumbosacral polyradiculomyelitis (ALP) in patients with AIDS is a well defined nosologic entity and classically associated to CMV infection. However, this pathology can be due to others etiologies as toxoplasmosis, syphilis, lymphoma, tuberculosis, cryptococcus, varicella-zoster virus fVZV), Epstein-Barr virus (EBT) and HSV associated CMV. The case report was documented with findings in cerebrospinal fluid, magnetic resonance imaging and was confirmed by detection of HSV DNA by polymerase chain reaction. CMV DNA was not detected and no clinical features of CMV disease was seen. Therapy with foscarnet was successful. This drug without gancyclovir associated has rarely been employed in the treatment of ALP. We believe that foscarnet may be a valuable alternative therapy for cases of ALP of suspected acyclovir-resistant herpes virus infection.
Miguélez
M
M
Servicio de Medicina Interna, Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife.
Correa-Nazco
V J
VJ
Linares
M
M
Laynez
P
P
González
M
M
Martínez
A
A
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004279:DNA, Viral / Q000032:analysis; D017245:Foscarnet / Q000008:administration & dosage / Q000627:therapeutic use; D006561:Herpes Simplex / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D009187:Myelitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016133:Polymerase Chain Reaction; D011128:Polyradiculopathy / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D018139:Simplexvirus / Q000235:genetics; D013997:Time Factors
D000998:Antiviral Agents; D004279:DNA, Viral; D018894:Reverse Transcriptase Inhibitors; D017245:Foscarnet