Yıl: 2021 Cilt: 27 Sayı: 1 Sayfa Aralığı: 91 - 94 Metin Dili: İngilizce DOI: 10.4274/tnd.2021.87259

Transvers Myelitis Due to HSV-2 Infection in an Undiagnosed HIV Positive Patient

Öz:
Several disorders including inflammatory, ischemic, and metabolic can cause longitudinally extensive transverse myelopathy. HIV-associated spinal cord involvement is rare. It can be due to AIDS-associated myelopathy, or opportunistic infections such as cytomegalovirus and herpes simplex virus (HSV). Herein, we describe a 49-year-old man who presented with acute paraparesis and urinary retention. His spinal magnetic resonance imaging revealed extensive hyperintense signal in the long TR sequence throughout C2 to T12, especially in the posterior and lateral columns. Both HIV ELISA test and HSV-2 DNA polymerase chain reaction were positive. Despite treatment, his clinical condition deteriorated. Acute transverse myelopathy can be the initial manifestation of an asymptomatic undiagnosed HIV positive patient. Viral serology reveals the opportunistic infections underlying the disease thereby guiding therapeutic regimens.
Anahtar Kelime:

Konular:
Fen > Tıp > Nörolojik Bilimler

Tanı Almamış HİV Pozitif Hastada HSV-2 Enfeksiyonuna Bağlı Transvers Miyelit

Öz:
Enflamatuvar, iskemik ve metabolik çok sayıda hastalık longitudinal uzun segment transvers miyelite neden olabilir. HIV enfeksiyonuna bağlı spinal tutulum nadirdir. Tutulum, AIDS ilişkili miyelopati ya da sitomegalovirüs ve herpes simpleks virüsü (HSV) gibi fırsatçı enfeksiyonlara bağlı gelişebilir. Olgumuz paraparezi ve üriner retansiyon kliniği ile başvuran 49 yaşında bir erkek hastadır. Hastanın spinal görüntülemelerinde özellikle posterolateral bölgede C2-T12 segmentleri arasında uzanan longitudinal geniş miyelopati tespit edilmiştir. HIV-ELISA testi ve HSV-2 DNA polimeraz zincir reaksiyonu pozitif saptanmıştır. Uygulanan medikal tedaviye rağmen hastanın kliniği progrese olmuştur. Akut transvers miyelopati, henüz tanı konmamış HIV pozitif bir hastada ilk bulgu olarak karşımıza çıkabilir. Viral seroloji altta yatan hastalığa bağlı fırsatçı enfeksiyonları tanımada ve uygulanacak tedavi kararında yol gösterici olacaktır.
Anahtar Kelime:

Konular:
Fen > Tıp > Nörolojik Bilimler
Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
  • 1. Sellner J, Boggild M, Clanet M, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol 2010;17:1019-1032.
  • 2. Koralnik IJ. Neurologic diseases caused by human immunodeficiency virus type 1 and opportunistic infections. In: by Mandell GL, Bennet JE, Dolin R, (eds). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Volume 1. 7th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010:1745-1764.
  • 3. Chong J, Rocco AD, Tagliati M, et al. MR Findings in AIDS-Associated Myelopathy. AJNR Am J Neuroradiol 1999;20:1412-1416.
  • 4. Widener RW, Whitley RJ. Herpes simplex virus. Handb Clin Neurol 2014;123:251-263.
  • 5. Nardone R, Versace V, Brigo F, et al. Herpes Simplex virus type 2 myelitis: Case report and review of the literature. Front Neurol 2017;8:199.
  • 6. Hauser SL, Ropper AH. Diseases of the spinal cord. In Harrison’s principles of internal medicine. Volume 2. 17th ed. In: Fauci AS, Braunwald E, Kasper DL, et al, (eds). United States of America: McGraw-Hill; 2008:2588-2596.
  • 7. Wingerchuk DM, Lennon VA, Pittock SJ, et al. Revised diagnostic criteria for neuromyelitis optica. Neurology 2006;66:1485-1489.
  • 8. O’Riordan JI, Gallagher HL, Thompson AJ, et al. Clinical, CSF, and MRI findings in Devic’s neuromyelitis optica. . J Neurol Neurosurg Psychiatry 1996;60:382-387.
  • 9. Lennon VA, Wingerchuk DM, Kryzer TJ, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 2004;364:2106-2112.
  • 10. Iyer A, Elsone L, Appleton R, et al. A review of the current literature and a guide to the early diagnosis of autoimmune disorders associated with neuromyelitis optica. Autoimmunity 2014;47:154-161.
  • 11. Boissé L, Gill MJ, Power C. HIV infection of the central nervous system: Clinical features and neuropathogenesis. Neurol Clin 2008;26:799-819.
  • 12. Whiteman MLH, Post MJD, Sklar EML. Neuroimaging of acquired immunodeficiency syndrome. In: Berger JR, Levy RM, (eds). AIDS and the Nervous System. 2nd ed. Philadelphia: Lippincott 1997;297-381.
  • 13. Baringer JR. Herpes simplex infections of the nervous system. Neurol Clin 2008;26:657-674.
  • 14. Kennedy PG, Rovnak J, Badani H, et al. A comparison of herpes simplex virus type 1 and varicella-zoster virus latency and reactivation. J Gen Virol 2015;96:1581-1602.
  • 15. Kyllerman MG, Herner S, Bergstrom TB, et al. PCR diagnosis of primary herpesvirus type I in poliomyelitis-like paralysis and respiratory tract disease. Pediatr Neurol 1993;9:227-229.
  • 16. Griffiths P. Cytomegalovirus infection of the central nervous system. Herpes 2004;11:95-104.
APA ÇOBAN E, SERİNDAĞ H, GÜL Z, TÜTÜNCÜ M, SOSYAL A (2021). Transvers Myelitis Due to HSV-2 Infection in an Undiagnosed HIV Positive Patient. Türk Nöroloji Dergisi, 27(1), 91 - 94. 10.4274/tnd.2021.87259
Chicago ÇOBAN Eda,SERİNDAĞ Helin Cansu,GÜL Zeynep BAŞTUĞ,TÜTÜNCÜ Mesude,SOSYAL Aysun Transvers Myelitis Due to HSV-2 Infection in an Undiagnosed HIV Positive Patient. Türk Nöroloji Dergisi 27, no.1 (2021): 91 - 94. 10.4274/tnd.2021.87259
MLA ÇOBAN Eda,SERİNDAĞ Helin Cansu,GÜL Zeynep BAŞTUĞ,TÜTÜNCÜ Mesude,SOSYAL Aysun Transvers Myelitis Due to HSV-2 Infection in an Undiagnosed HIV Positive Patient. Türk Nöroloji Dergisi, vol.27, no.1, 2021, ss.91 - 94. 10.4274/tnd.2021.87259
AMA ÇOBAN E,SERİNDAĞ H,GÜL Z,TÜTÜNCÜ M,SOSYAL A Transvers Myelitis Due to HSV-2 Infection in an Undiagnosed HIV Positive Patient. Türk Nöroloji Dergisi. 2021; 27(1): 91 - 94. 10.4274/tnd.2021.87259
Vancouver ÇOBAN E,SERİNDAĞ H,GÜL Z,TÜTÜNCÜ M,SOSYAL A Transvers Myelitis Due to HSV-2 Infection in an Undiagnosed HIV Positive Patient. Türk Nöroloji Dergisi. 2021; 27(1): 91 - 94. 10.4274/tnd.2021.87259
IEEE ÇOBAN E,SERİNDAĞ H,GÜL Z,TÜTÜNCÜ M,SOSYAL A "Transvers Myelitis Due to HSV-2 Infection in an Undiagnosed HIV Positive Patient." Türk Nöroloji Dergisi, 27, ss.91 - 94, 2021. 10.4274/tnd.2021.87259