[A case of probable cytomegalovirus encephalitis who restored from persistant disturbance of consciousness].
A 50-year-old woman presented with confusion, fever and drowsiness following an episode of headache and dizziness. On admission, neurological examination found positive pyramidal tract signs, meningeal irritation, and bilateral myoclonus in her arms. Laboratory tests revealed liver dysfunction, positive inflammatory reaction, elevated serum IgM antibody against cytomegalovirus, and increased cerebrospinal fluid protein of 67 mg/dl. MRI of brain by diffusion weighted imaging showed a wide spread hyperintense lesion in white matter and limbic areas. We administered aciclovir, ganciclovir and steroid pulse therapy that showed a limited effect in the initial stage. In spite of all these therapies, she suffered from status epilepticus, followed by persistent disturbance of consciousness for about 2 months. However, her level of consciousness and motor deficit were gradually improved by continuous administration of ganciclovir. The present case indicates that prolonged disturbance of consciousness due to cytomegalovirus encephalitis could be restored with continuous ganciclovir administration.
Toyoda
Genya
G
Department of Internal Medicine III, Faculty of Medicine, Shimane University.
Iijima
Ken-ichi
K
Takahashi
Kazuo
K
Bokura
Hirokazu
H
Yamaguchi
Shuhei
S
D000998:Antiviral Agents / Q000627:therapeutic use; D003244:Consciousness Disorders / Q000503:physiopathology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000503:physiopathology*; D018792:Encephalitis, Viral / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged
D000998:Antiviral Agents; D015774:Ganciclovir