Prognosis and response to therapy of cytomegalovirus encephalitis and meningomyelitis in AIDS

Neurology
B A Cohen

Abstract

Effective diagnosis and treatment of cytomegalovirus infection of the nervous system in AIDS patients has been limited by a lack of sensitive diagnostic measures. Retrospective series suggest a poor prognosis for cytomegalovirus encephalitis with rapid mortality. Polymerase chain reaction amplification of cytomegalovirus DNA allows detection in CSF that appears specific for CNS infection. In this series of seven patients with CNS cytomegalovirus infection in AIDS, four patients responded to therapy. Serial determinations of cytomegalovirus DNA in CSF in five patients revealed persistent detection in two treatment failures and absence of detection in three responders on subsequent CSF samples. A prospective trial to determine optimal therapy and to confirm the utility of cytomegalovirus DNA in CSF as a marker of the course of cytomegalovirus infection in the CNS is warranted and should consider prior therapy for cytomegalovirus, prior opportunistic infections, and leukoencephalopathy as potential prognostic variables.

Citations

May 23, 2003·Current Infectious Disease Reports·William Lawrence Drew
Dec 18, 2008·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·R Pirskanen-MatellA Ehrnst
May 8, 2002·CNS Drugs·Matthias MaschkeHans-Christoph Diener
Aug 20, 2014·The Medical Clinics of North America·Margaret L Isaac, Eric B Larson
Nov 18, 2004·Journal of the Neurological Sciences·Makoto MatsuiYasuo Kuroda
Jan 5, 2002·Neurologic Clinics·Joseph R Zunt

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