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Progressive Encephalopathy Associated With Cytomegalovirus Infection Without Immune Deficiency

Division of Child Neurology

Masumi Inagaki, MD

Division of Child Neurology

Hitoshi Kawahara, MD

Division of Child Neurology

Kuniyasu Takada, MD

Division of Neuropathology, Institute of Neurological Sciences, Tottori University School of Medicine, Nishimachi, Yonago

Yoshito Eizuru, MD

Department of Microbiology, Miyazaki Medical College, Miyazaki, Japan

Toshio Minematsu, MD

Department of Microbiology, Miyazaki Medical College, Miyazaki, Japan

Yoichi Minamishima, MD

Department of Microbiology, Miyazaki Medical College, Miyazaki, Japan

Slowly progressive encephalopathy caused by cytomegalovirus is an unusual disorder, and its pathogenesis remains unknown except for cases associated with the acquired immune deficiency syndrome and organ transplantation. We report a case who showed clinical features of progressive encephalopathy. Cytomegalovirus was repeatedly isolated from urine, and cytomegalovirus-infected cells were detected in bone marrow. Serial computed tomographic head scan revealed periventricular calcification and its progression to the thalamus, cerebellum, and brain stem. On autopsy, there were multiple calcifications and diffuse glial proliferation in the gray and white matter. Perivascular inflammation was only minimal. There was no evidence of immune deficiency. This case suggests that progressive encephalopathy can be caused by cytomegalovirus infection without immune deficiency. This type of cytomegalovirus infection may be unusual, but its serious outcome should remind us to detect it accurately. (J Child Neurol 1993;8:373-377).

Journal of Child Neurology, Vol. 8, No. 4, 373-377 (1993)
DOI: 10.1177/088307389300800415


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