title: Rapidly progressed acquired immunodeficiency syndrome dementia complex as an initial manifestation.
abstract: We report a patient with acquired immunodeficiency syndrome dementia complex (ADC) that presented human immunodeficiency virus infection as an initial manifestation. A 34-year-old man developed disturbance of consciousness and severe abulia over 3 months. The CD4 lymphocyte count was 7.9/microl, while human immunodeficiency virus RNA in blood amounted to 4.2 x 10(4) copies/ml. T2-weighted magnetic resonance imaging showed diffusely high signal intensity in the deep white matter of both cerebral hemispheres. On the 20th hospital day, the patient died of sepsis caused by methicillin-resistant Staphylococcus aureus. Autopsy findings in the brain included increased glial cells and multinucleated giant cells in cerebral white matter and subcortical gray matter. These features were compatible with ADC.
authors.affiliation: Department of Hematology, National Hospital Organization, Minami-Okayama Medical Center, Okayama.
authors.forename: Makoto
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Keigo
authors.initials: K
authors.lastname: Nobukuni
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takata
authors.forename: Noriko
authors.initials: N
authors.lastname: Kawata
authors.forename: Noriko
authors.initials: N
authors.lastname: Hayashibara
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishizu
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001921:Brain / Q000473:pathology; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009457:Neuroglia / Q000473:pathology; D013997:Time Factors