A Case of Cytomegalovirus Lumbosacral Polyradiculopathy in Acquired Immune Deficiency Syndrome

ABSTRACT

BACKGROUND AND SIGNIFICANCE: Cytomegalovirus(CMV) is the most common opportunistic viral agent encountered in AIDS and its relation to peripheral neuropathy and rapidly developing lumbosacral polyradiculopathy has been well documentated. CASE A 30-year-old man with acquired immune deficiency syndrome presented with rapidly progressive paraplegia and voiding difficulty. Electrophysiologic studies revealed a lumbosacral polyradiculopathy with loss of bulbocavernous reflex and CSF examination showed polymorphonuclear pleocytosis with elevated protein level. Also, spinal T1-weighted MRI with gadolinium-DTPA showed enhancement of the pial lining of the conus medullaris, cauda equina, and lumbar nerve roots. Anti CMV titers were elevated in CSF and culture for CMV in both blood and urine was positive. The patient was treated with ganciclovir. CONCLUSION: We report a case of polyradiculopathy related to CMV in a patient with acquired immune deficiency syndrome(AIDS). It seems to be important to differentiate this unique syndrome from other causes of rapidly developing paraplegia syndromes among AIDS patients.