ABSTRACT
Human Immunodeficiency Virus associated neurocognitive dysfunction can present as a case of movement disorder in a patient with prolonged antiretroviral therapy. Diagnosis was made after ruling out space occupying lesions, nutritional deficiencies and infectious causes through brain imaging and cerebrospinal fluid analysis. With multidisciplinary care and change of antiretroviral therapy to drugs with higher cerebrospinal fluid penetration, symptoms of the patient improved over a span of six months. Delayed neurological damage due to Human Immunodeficiency Virus can present with isolated cerebellar symptoms.
Subject(s)
AIDS Dementia Complex/diagnostic imaging , Anti-HIV Agents/therapeutic use , Brain Stem/diagnostic imaging , Cerebellar Ataxia/diagnostic imaging , Cerebellum/diagnostic imaging , HIV Infections/drug therapy , AIDS Dementia Complex/drug therapy , AIDS Dementia Complex/physiopathology , Alkynes/therapeutic use , Benzoxazines/therapeutic use , Blood-Brain Barrier , Cerebellar Ataxia/physiopathology , Cyclopropanes/therapeutic use , Drug Substitution , Female , Gait Ataxia/diagnostic imaging , Gait Ataxia/physiopathology , Humans , Lamivudine/therapeutic use , Magnetic Resonance Imaging , Mesencephalon/diagnostic imaging , Middle Aged , Neurodegenerative Diseases/diagnostic imaging , Neurodegenerative Diseases/physiopathology , Nystagmus, Pathologic/diagnostic imaging , Nystagmus, Pathologic/physiopathology , Panic Disorder/physiopathology , Pons/diagnostic imaging , Postural Balance/physiology , Sensation Disorders/diagnostic imaging , Sensation Disorders/physiopathology , Tenofovir/therapeutic use , Zidovudine/therapeutic useABSTRACT
A 43-year-old male patient developed varicella virus (chickenpox) 4 months after receiving a liver transplant. Within 5 days of complete recovery, he presented with widespread cutaneous vesicular eruptions involving the face, back, abdomen, and upper extremities. Tzanck smear showed ground glass inclusions in the nuclei of multinucleated giant cells, suggestive of viral pathology. The patient was subsequently diagnosed with Kaposi varicelliform eruption, a rare dermatologic emergency. He was treated with high-dose intravenous acyclovir and fully recovered.
