title: Human immunodeficiency virus (HIV) infection in a child presenting as acute disseminated encephalomyelitis.
abstract: Acute disseminated encephalomyelitis is an extremely rare occurrence in human immunodeficiency virus (HIV) infection. We describe an 8-year-old male child who presented with weakness of both lower limbs for 10 days and focal convulsions for 2 days. The child had left, upper motor neuron facial palsy, lower limb hypotonia, and exaggerated deep tendon reflexes. Enzyme-linked immunosorbent assay antibodies for HIV tested positive and the CD4 count was 109 cells/µL. The magnetic resonance imaging (MRI, brain) revealed extensive confluent hyperintensities (on T2-weighted images) in left parietal, right temporal, and right occipital regions of the white matter, and similar signals were seen in right lentiform nucleus and right posterior thalami, suggesting acute disseminated encephalomyelitis. There was transient improvement with intravenous methyl prednisolone. The patient succumbed to the illness. Perinatally transmitted pediatric HIV infection presenting with acute disseminated encephalomyelitis has not yet been reported in the medical literature.
authors.affiliation: Department of Pediatrics, KEM Hospital, Mumbai, Maharashtra, India. milindtullu@vsnl.net
authors.forename: Milind S
authors.initials: MS
authors.lastname: Tullu
authors.forename: Dhananjay P
authors.initials: DP
authors.lastname: Patil
authors.forename: Mamta N
authors.initials: MN
authors.lastname: Muranjan
authors.forename: Archana S
authors.initials: AS
authors.lastname: Kher
authors.forename: Keya R
authors.initials: KR
authors.lastname: Lahiri
mesh_terms: D001921:Brain / Q000473:pathology*; D002648:Child; D004673:Encephalomyelitis, Acute Disseminated / Q000209:etiology* / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male