[Lesions of the conus medullaris and the cauda equina caused by cytomegalovirus in HIV infection. 7 cases].

Abstract

OBJECTIVES Neurologic infections caused by cytomegalovirus are common in patients with acquired immunodeficiency syndrome (AIDS). The prognosis is particularly severe when the infection is localized in the conus medullaris and/or the cauda equina. METHODS Among the 861 patients with AIDS treated in our unit from 1991 to 1993, 7 cases involving cytomegalovirus infection of the conus medullaris and/or the cauda equina were studied retrospectively. RESULTS OF THE CASE REPORTS: Clinical manifestations were nearly always the same: low back pain, motor deficiency in the lower limbs progressing to flaccid paraplegia and sphincter failure. The cerebrospinal fluid contained a high cell count with unaltered polynuclears and increased protein levels. In 6/7 patients virus cultures and search for the viral genome in the cerebrospinal fluid were positive. The clinical course was favourable in 6 patients after 3 weeks treatment with ganciclovir and/or foscarnet. Virology tests became negative in three-fourths of the patients. Nevertheless, relapse occurred after 4.2 weeks despite long-term therapy. CONCLUSION The severe clinical course of this disease and the gravity of constantly fatal relapse requires highly adapted treatment and overall health care.

Cite this paper

@article{Jacomet1995LesionsOT, title={[Lesions of the conus medullaris and the cauda equina caused by cytomegalovirus in HIV infection. 7 cases].}, author={C. Jacomet and M G Lebrette and Mohammed El Amrani and Laura Monfort and Jo{\"{e}l Gozlan and P M Girard and Willy Rozenbaum}, journal={Presse medicale}, year={1995}, volume={24 11}, pages={527-30} }