CMV ventriculitis and encephalitis

Case contributed by Frank Gaillard

Presentation

HIV positive adult patient with very low CD4+ count presents with altered conscious state.

MRI demonstrates numerous periventricular high T2 signal regions which restrict on DWI. The additional high signal on T2 and DWI is seen lining the ependymal surface of the lateral ventricles, which also demonstrates faint enhancement.

Findings are consistent with CMV infection.

Case Discussion

The patient went on to have a vitreous biopsy and lumbar puncture. CSF was positive for CMV on PCR and positive culture of CMV was obtained from vitreous biopsy.

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