What are the signs and symptoms of cytomegalovirus (CMV) encephalitis in HIV?

Updated: Jul 25, 2017
  • Author: Regina Krel, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Answer

HIV-associated cytomegalovirus (CMV) encephalitis can present in different ways, including the following:

  • CMV encephalitis may be asymptomatic

  • CMV encephalitis characterized by ventriculoencephalitis manifests with abrupt onset and rapidly progressive confusion and lethargy

  • Cranial nerve palsies, most often oculomotor and facial, and other focal neurologic deficits occur

  • CMV encephalitis characterized by microglial nodules and focal parenchymal necrosis manifests with a more indolent change in mental status, very similar to AIDS dementia complex (ADC)

CMV encephalitis may occur in conjunction with CMV-associated colitis, esophagitis, retinitis, myelitis, radiculoganglionitis, neuropathy, or adrenal insufficiency, often in patients already receiving ganciclovir. A strong association between CMV retinitis and encephalitis is apparent. In an autopsy series of 47 patients with AIDS, 75% of those with CMV retinitis involving the peripapillary area also had encephalitis. [2]


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