HIV positive adult patient with altered conscious state.
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Multiple foci of periventricular diffusion restriction.
MRI in a HIV positive patient with very low CD 4+ count demonstrates numerous periventricular high T2 signal regions which restrict on DWI. Additional high signal on T2 and DWI is seen lining the ependymal surface of the lateral ventricles, which also demonstrates faint enhancement.
Finding are consistent with CMV infection. Positive CMV PCR on CSF and positive culture of CMV from vitreous biopsy.