Which CSF findings are characteristic of CMV-related progressive polyradiculopathy in HIV infection?

Updated: Nov 05, 2019
  • Author: Emad R Noor, MBChB; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Answer

In CMV-related polyradiculopathy, typical CSF findings are as follows:

  • Decreased glucose level

  • Markedly elevated protein level, but can be normal

  • Polymorphonuclear neutrophil (PMN)–predominant pleocytosis. One case report showed lymphocytic predominance.

  • Positive PCR for CMV

  • Absence of malignant cells

Pleocytosis usually comprises more than 60% PMNs, but the percentage is sometimes lower. In one study, only 50% of patients had PMN-preponderant pleocytosis. Positive CMV-PCR and elevated protein were the most common CSF findings. [19]

PCR of CSF has a 92% sensitivity and a 94% specificity in CMV-associated progressive polyradiculopathy. CMV culture is positive in only 50% of cases.


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