Journal Article

Microglial Nodular Encephalitis and Ventriculoencephalitis Due to Cytomegalovirus Infection in Patients with AIDS: Two Distinct Clinical Patterns

M. P. Grassi, F. Clerici, C. Perin, A. d'Arminio Monforte, L. Vago, M. Borella, R. Boldorini and A. Mangoni

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 3, pages 504-508
Published in print September 1998 | ISSN: 1058-4838
Published online September 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514682
Microglial Nodular Encephalitis and Ventriculoencephalitis Due to Cytomegalovirus Infection in Patients with AIDS: Two Distinct Clinical Patterns

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In patients with AIDS, cerebral infection due to cytomegalovirus (CMV) results in two distinct neuropathological patterns: microglial nodular encephalitis (MGNE) and ventriculoencephalitis (VE). In order to identify clinical features to facilitate the differential diagnosis of these two forms of CMV encephalopathy in living patients, we retrospectively reviewed the clinical records of 18 patients with MGNE or VE diagnosed at autopsy. We identified the following clinical features as distinguishing the two encephalopathies: (1) MGNE manifests earlier than VE; (2) the onset of MGNE is acute, whereas the onset of VE is insidious; (3) the onset of MGNE is marked by confusion and delirium, which do not occur in VE; (4) VE is frequently associated with radiculopathy, which is absent in MGNE; and (5) VE is associated with more marked alterations in cerebrospinal fluid (high protein levels and pleocytosis). The early neurological manifestations of MGNE should prompt a search for systemic CMV infection, which may lead to earlier treatment.

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

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