CMV and HSV-2 myeloradiculitis in an HIV infected patient

Abstract

SUMMARYWhile 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.

A Rare Case of Cytomegalovirus and Herpes Simplex Virus Coinfection Gastritis and Colitis in a Person Living With HIV/AIDS

“…[11][12][13] Organ manifestations include meningoencephalitis, pneumonitis, and hepatitis. [14][15][16] Herpes simplex virus colitis is a rare presentation with only a few cases reported in the literature. All reported cases of HSV colitis have been associated with either underlying bowel disease, such as IBD, 17 colon cancer, 18 or profound immunosuppression, such as in patients after solid organ transplantation.…”

A Rare Case of Paraparesis

“…Herpes simplex virus 2 myeloradiculitis is rare and often associated with disabling outcome. 6 The imaging in the patients suffering from retrovirus mostly show contrast enhancement at conus medullaris and cauda equina. Herpes simplex virus 2 can also involve sacral region resulting in sacral myeloradiculitis with a fatal outcome in most of the patients.…”