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Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature

Patient: Female, 46 Final Diagnosis: CMV gastroparesis and radiculopathy Symptoms: Nausea • paraplegia • urinary retention • vomiting Medication: — Clinical Procedure: Lumbar puncture Specialty: Infectious Diseases OBJECTIVE: Unusual clinical course BACKGROUND: Cytomegalovirus (CMV) infection has be...

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Autores principales: Thongpooswan, Supat, Chyn, Eric, Alfishawy, Mostafa, Restrepo, Erfidia, Berman, Charles, Ahmed, Kawser, Muralidharan, Sethu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644015/
https://www.ncbi.nlm.nih.gov/pubmed/26552851
http://dx.doi.org/10.12659/AJCR.894512
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author Thongpooswan, Supat
Chyn, Eric
Alfishawy, Mostafa
Restrepo, Erfidia
Berman, Charles
Ahmed, Kawser
Muralidharan, Sethu
author_facet Thongpooswan, Supat
Chyn, Eric
Alfishawy, Mostafa
Restrepo, Erfidia
Berman, Charles
Ahmed, Kawser
Muralidharan, Sethu
author_sort Thongpooswan, Supat
collection PubMed
description Patient: Female, 46 Final Diagnosis: CMV gastroparesis and radiculopathy Symptoms: Nausea • paraplegia • urinary retention • vomiting Medication: — Clinical Procedure: Lumbar puncture Specialty: Infectious Diseases OBJECTIVE: Unusual clinical course BACKGROUND: Cytomegalovirus (CMV) infection has been well described as an opportunistic infection of patients with human immunodeficiency virus (HIV). To the best of our knowledge, this is the first case report of a patient with AIDS and lumbosacral polyradiculopathy, associated with gastroparesis resulting from CMV infection. CASE REPORT: A 46-year-old Hispanic woman with a history of HIV for 10 years was admitted to our hospital for nausea, vomiting, urinary retention, and generalized weakness. Bilateral lower extremity examination revealed flaccid paraplegia, decreased sensations from the groin downwards, bilateral lower extremity areflexia, and absent plantar reflexes, with enlarged urinary bladder. CMV was detected in CSF by PCR, and cervical and lumbar magnetic resonance imaging (MRI) revealed intense nodular leptomeningeal enhancement from the lower thoracic cord and extending along the conus medullaris/filum terminalis and nerve roots. Gastric emptying scintigraphy revealed severe delayed gastric emptying time. Ganciclovir was initiated and her neurological symptoms and gastrological symptoms gradually improved. Over 8 weeks, nausea and vomiting resolved and the patient was able to walk before being discharged from the hospital. CONCLUSIONS: Polyradiculopathy and gastroparesis can result from CMV infection in AIDS patients. Whether the mechanism is secondary to viral infection or immune systems remains unclear. It is important for physicians to be aware of this uncommon presentation in the antiretroviral therapy (ART) era. CMV treatment should be initiated immediately once diagnosis is confirmed.
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spelling pubmed-46440152015-11-23 Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature Thongpooswan, Supat Chyn, Eric Alfishawy, Mostafa Restrepo, Erfidia Berman, Charles Ahmed, Kawser Muralidharan, Sethu Am J Case Rep Articles Patient: Female, 46 Final Diagnosis: CMV gastroparesis and radiculopathy Symptoms: Nausea • paraplegia • urinary retention • vomiting Medication: — Clinical Procedure: Lumbar puncture Specialty: Infectious Diseases OBJECTIVE: Unusual clinical course BACKGROUND: Cytomegalovirus (CMV) infection has been well described as an opportunistic infection of patients with human immunodeficiency virus (HIV). To the best of our knowledge, this is the first case report of a patient with AIDS and lumbosacral polyradiculopathy, associated with gastroparesis resulting from CMV infection. CASE REPORT: A 46-year-old Hispanic woman with a history of HIV for 10 years was admitted to our hospital for nausea, vomiting, urinary retention, and generalized weakness. Bilateral lower extremity examination revealed flaccid paraplegia, decreased sensations from the groin downwards, bilateral lower extremity areflexia, and absent plantar reflexes, with enlarged urinary bladder. CMV was detected in CSF by PCR, and cervical and lumbar magnetic resonance imaging (MRI) revealed intense nodular leptomeningeal enhancement from the lower thoracic cord and extending along the conus medullaris/filum terminalis and nerve roots. Gastric emptying scintigraphy revealed severe delayed gastric emptying time. Ganciclovir was initiated and her neurological symptoms and gastrological symptoms gradually improved. Over 8 weeks, nausea and vomiting resolved and the patient was able to walk before being discharged from the hospital. CONCLUSIONS: Polyradiculopathy and gastroparesis can result from CMV infection in AIDS patients. Whether the mechanism is secondary to viral infection or immune systems remains unclear. It is important for physicians to be aware of this uncommon presentation in the antiretroviral therapy (ART) era. CMV treatment should be initiated immediately once diagnosis is confirmed. International Scientific Literature, Inc. 2015-11-10 /pmc/articles/PMC4644015/ /pubmed/26552851 http://dx.doi.org/10.12659/AJCR.894512 Text en © Am J Case Rep, 2015 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License
spellingShingle Articles
Thongpooswan, Supat
Chyn, Eric
Alfishawy, Mostafa
Restrepo, Erfidia
Berman, Charles
Ahmed, Kawser
Muralidharan, Sethu
Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature
title Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature
title_full Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature
title_fullStr Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature
title_full_unstemmed Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature
title_short Polyradiculopathy and Gastroparesis due to Cytomegalovirus Infection in AIDS: A Case Report and Review of Literature
title_sort polyradiculopathy and gastroparesis due to cytomegalovirus infection in aids: a case report and review of literature
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644015/
https://www.ncbi.nlm.nih.gov/pubmed/26552851
http://dx.doi.org/10.12659/AJCR.894512
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