title: CMV and HSV-2 myeloradiculitis in an HIV infected patient.
abstract: While CMV myeloradiculitis is a known complication in AIDS patients with severe immunosuppression, HSV-2 necrotizing myeloradiculitis is rare and often associated with disabling a fatal outcome. We hereby describe a 46 year-old HIV infected patient with profound and sustained immunosuppression who presented with an acute ascending paraparesis and urinary retention. Lumbar spine MRI showed contrast enhancement at the conus medullaris and cauda equine, and both CMV and HSV-2 CSF PCR were positive. Despite treatment, the patient died 20 days later. We review the main diagnostic and therapeutic aspects of herpes virus associated myeloradiculitis and discuss the approach in similar cases.
authors.affiliation: Instituto de Pesquisa Clínica Evandro Chagas, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Pinto
authors.forename: Edwiges
authors.initials: E
authors.lastname: Santos
authors.forename: Danusa F
authors.initials: DF
authors.lastname: Correa
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Escada
authors.forename: Carla de Mello
authors.initials: Cde M
authors.lastname: Vorsatz
authors.forename: Sandra Wagner
authors.initials: SW
authors.lastname: Cardoso
authors.forename: Marco A
authors.initials: MA
authors.lastname: Lima
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications*; D004279:DNA, Viral / Q000134:cerebrospinal fluid; D017809:Fatal Outcome; D006561:Herpes Simplex / Q000150:complications*; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000150:complications* / Q000821:virology
chemical_list: D004279:DNA, Viral