Cerebral mass lesion due to cytomegalovirus in a patient with AIDS: case report and literature review


Autoria(s): Vidal,José E.; Dauar,Rafi F.; Penalva de Oliveira,Augusto C.; Coelho,João F.G.S.; Lins,Diogo L.M.
Data(s)

01/12/2003

Resumo

Cytomegalovirus (CMV) disease in acquired immunodeficiency syndrome (AIDS) patients most commonly presents as chorioretinitis and gastro-intestinal infection. Neurological involvement due to CMV may cause several clinical presentations: polyradiculitis, myelitis, encephalitis, ventriculo-encephalitis, and mononeuritis multiplex. Rarely, cerebral mass lesion is described. We report a 39 year-old woman with AIDS and previous cerebral toxoplasmosis. She presented with fever, seizures, and vulval ulcers. Her chest X-ray showed multiple lung nodules, and a large frontal lobe lesion was seen in a brain computed tomography scan. She underwent a brain biopsy through a frontal craniotomy, but her condition deteriorated and she died in the first postoperative day. Histopathological studies and immunohistochemistry disclosed CMV disease, and there was no evidence of cerebral toxoplasmosis, bacterial, mycobacterial or fungal infection. CMV disease should be considered in the differential diagnosis of cerebral mass lesion in AIDS patients. High suspicion index, timely diagnostic procedures (surgical or minimally invasive), and proper utilization of prophylactic and therapeutic medication could improve outcome of these patients.

Formato

text/html

Identificador

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652003000600007

Idioma(s)

en

Publicador

Instituto de Medicina Tropical

Fonte

Revista do Instituto de Medicina Tropical de São Paulo v.45 n.6 2003

Palavras-Chave #Cerebral mass lesion #Focal brain mass #Intracranial mass lesion #Focal neurological disease #Cytomegalovirus #Acquired immunodeficiency syndrome
Tipo

journal article