Ana Sofia da Costa Matos1*, João Pedro Pais1, Ana Rita Cambão1, Ana Isabel Viana Nascimento1 and Diana Gomes Costa Guerra1
Serviço de Medicina 1, Unidade Local de Saúde do Alto Minho, Hospital de Santa Luzia, PortugalFulltext PDF
Acute human immunodeficiency virus infection is associated with a nonspecific systemic syndrome in about 70% of cases, however neurological manifestations are present in only a small subset of patients. The authors report the case of a 70-year-old man admitted to the emergency department for behavioral changes, gait imbalance, dysmetria and fever, macular lesions on the chest and limbs and small penile ulcers. Blood analysis showed pancytopenia, peripheral blood smears with atypical lymphocytes and presence of HIV antigens in the absence of serum antibodies. The serum HIV- 1 viral load was over 10000000 copies/ml, which confirmed primary HIV infection. CSF analysis showed elevated protein concentration (67.2 mg/dl) and viral load of 15,990 copies/ml, leading to the diagnosis of HIV encephalitis. Initiated antiretroviral therapy with resolution of cognitive impairment, improvement of pancytopenia and CD4+ count, as well as reduction of viral load.
da Costa Matos AS, Pais JP, Cambão AR, Viana Nascimento AI, Costa Guerra DG. Acute Encephalitis as Presentation of Primary HIV Infection - Case Report. Ann Clin Case Rep. 2020; 5: 1787..