Journal Article

Cytomegalovirus Polyradiculopathy in Patients with AIDS

Hans-Joachim Anders and Frank-Detlef Goebel

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 2, pages 345-352
Published in print August 1998 | ISSN: 1058-4838
Published online August 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514663
Cytomegalovirus Polyradiculopathy in Patients with AIDS

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Using the MEDLINE database, we evaluated 103 cases of AIDS-related cytomegalovirus (CMV) polyradiculopathy (PRP). In 13% of cases, PRP was the initial manifestation of AIDS. Hyporeflexia was present in 100% of cases; lower limb weakness, in 100%; urinary retention, in 94%; paresthesia, in 79%; sensory loss, in 80%; and a Babinski's sign, in 16%. Mean cerebrospinal fluid (CSF) parameters ± SD were as follows: white blood cell count, 651 ± 1,053 × 106/L; protein level, 2.28 ± 1.78 g/L; and CSF/serum glucose ratio, 0.48 ± 0.17. Gadolinium enhancement of meninges on a magnetic resonance image and abnormalities on a myelogram were noted in 31% and 17% of cases, respectively. Mean survival time ± SD was 5.4 ± 1.8 weeks for untreated patients and 14.6 ± 9.4 weeks for patients treated with ganciclovir (P < .0001), but it was only 7.2 ± 3.0 weeks for patients receiving ganciclovir treatment at the onset of PRP. CMV-related PRP is an uncommon but distinctive complication of AIDS. Early diagnosis is possible, and other causes can be excluded by lumbar magnetic resonance imaging and by the presence of typical CSF changes, as shown by polymerase chain reaction of CMV. Retrospectively, survival time for naive patients was increased by ganciclovir therapy and may even be underestimated in this evaluation of historical reports.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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