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Brain multiple focal processes in a HIV positive patient – a case report

Publication at Faculty of Medicine in Pilsen |
2013

Abstract

A case report of a 42-year-old HIV positive woman, who from 2002 fulfilled the AIDS-definition criteria, is presented. She was successfully treated with combined antiretroviral therapy (cART) immediately after confirmation of the AIDS diagnosis.

She was in a good clinical condition and her immunological status was also promising. During 2009, a slow progression of neurological ymptoms was observed, originally simulating the clinical picture of multiple sclerosis (MS).

MRI repeatedly showed multiple lesions in the gray and white brain matters and in the oblongata. The performed investigations did not verify MS, no pathogens other than enteroviruses were found in the CSF.

Coxsackie B5, as a probable cause of severe encephalitis, was confirmed by the National Reference Laboratory in Prague by phenotype determination methods. As reported in the literature, enteroviruses can cause various forms of encephalititis, including MS-like syndrome, especially in people suffering from HIV infection.

This case report is describing probably the first intra-vitam confirmed encephalitis caused by enteroviruses in a HIV-positive person in the Czech Republic.