Successful Treatment of Cytomegalovirus Polyradiculopathy in a 9-year-old Child With Congenital Human Immunodeficiency Virus Infection

Sohal, Aman; Riordan, Andrew; Mallewa, Mac; Solomon, Tom; Kneen, Rachel

doi:10.1177/0883073808322671

Cited by 9 publications

(3 citation statements)

References 13 publications

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“…CMV infection that manifests as polyradiculopathy is rare in children; it is more common in adults. Those with a history of solid organ transplantation are particularly susceptible to central nervous system (CNS) infections (including CMV infection) for the first 6 months after transplantation (27,28).…”

Section: Acquired CMV Infection Epidemiology and Clinical Featuresmentioning

confidence: 99%

Neuroimaging of Pediatric Central Nervous System Cytomegalovirus Infection

et al. 2010

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Cytomegalovirus (CMV) is a ubiquitous virus that usually results in asymptomatic or clinically benign infection. However, there are two groups of patients whose response to CMV infection is much more severe: those who are infected during fetal development and those who are immunocompromised. Although the manifestations of these types of infection differ, both often result in substantial neurologic sequelae. Imaging plays a key role in the diagnosis of both congenital and acquired CMV infection. Neurologic findings of congenital CMV infection include intracranial calcification, migrational abnormalities, cerebral and cerebellar volume loss, ventriculomegaly, and white matter disease. The presence of these findings in children with neurodevelopmental delays is suggestive of congenital CMV infection, even if the child was asymptomatic at birth. Certain imaging features also may indicate future neurologic deficits in symptomatic infants. Acquired CMV infection is potentially deadly in immunocompromised patients such as those infected with human immunodeficiency virus or with acquired immune deficiency syndrome and those with a history of solid organ or bone marrow transplantation. Imaging findings of acquired CMV infection often are nonspecific; however, they may indicate a need for further serologic analysis to determine if CMV infection is present. Early recognition and treatment of central nervous system CMV infection is vital for effective treatment, and familiarity with the imaging findings of this common infection is important for accurate diagnosis.

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Section: Acquired CMV Infection Epidemiology and Clinical Featuresmentioning

confidence: 99%

Neuroimaging of Pediatric Central Nervous System Cytomegalovirus Infection

et al. 2010

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“…Whilst all five viruses can cause meningitis in HIV-infected adults, EBV infection is more usually associated with central nervous system (CNS) lymphoma, whilst CMV is more frequently the cause of encephalitis, radiculitis or retinitis [5, 7–9]. …”

Section: Introductionmentioning

confidence: 99%

Detection of herpes viruses in the cerebrospinal fluid of adults with suspected viral meningitis in Malawi

et al. 2012

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“…Most of these conditions, especially distal symmetrical polyneuropathy, are more recognized in adult patients with HIV-1 infection. Peripheral neuropathy in children with HIV has not been extensively studied, but is also described in the form of AIDP at the time of seroconversion as an immune reconstitution phenomenon, and in relation to secondary infection with Cytomegalovirus [25][26][27][28][29]. In differentiating between AIDP in children who are not infected with HIV and those undergoing seroconversion, the former future science group Special Report Wilmshurst CME [106,107] Patients can suffer painful radiculoneuropathy [108] Vasculitis Tangier disease Rare autosomal recessive mutation of ABCA1 gene leading to reduced levels of plasma high-density lipoprotein: children tend to present with large yellow-orange tonsils [109] Adults are more likely to have neuropathy that can be remitting/relapsing mono-/poly-neuropathy or a syringomyelia-like neuropathy [110] Acute intermittent porphyria…”

Section: Recognition Of Etiologiesmentioning

confidence: 99%

Diagnosis and Management of Pediatric Peripheral Neuropathies In Resource-Poor Settings

Wilmshurst

2013

Future Neurol.

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The diagnosis of a peripheral neuropathy in a child who resides in the majority of resource-poor settings is based on the history taken and the clinical examination. The majority of children, unless they demonstrate additional clinical markers, will lack a more definitive diagnosis beyond the label ‘peripheral neuropathy’. The treatable, typically acquired conditions, which are prevalent in these settings, are the priority to identify. This would include neuroinfections, neuroinflammation, toxins and vitamin deficiencies. The management of children with peripheral neuropathies in resource-poor settings must be approached in a different manner to that of more ‘resource-equipped’ settings. Secondary or tertiary centers are scarce, often significant distances away from the patient, and this leads to long delays before access is possible. Most children present to primary healthcare settings and are seen by practitioners with little training in the features suggestive of a peripheral neuropathy. As such, basic aids to assist the healthcare worker in the early recognition and interventions of a child with a peripheral neuropathy are important. In addition, there must be recognition of the child with a rapidly progressive neuropathy where a life-threatening condition is present, and urgent referral to a tertiary setting made wherever possible.

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Successful Treatment of Cytomegalovirus Polyradiculopathy in a 9-year-old Child With Congenital Human Immunodeficiency Virus Infection

Cited by 9 publications

References 13 publications

Neuroimaging of Pediatric Central Nervous System Cytomegalovirus Infection

Neuroimaging of Pediatric Central Nervous System Cytomegalovirus Infection

Detection of herpes viruses in the cerebrospinal fluid of adults with suspected viral meningitis in Malawi

Diagnosis and Management of Pediatric Peripheral Neuropathies In Resource-Poor Settings

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