CMV Encephalitis with Brain Stem Involvement without Evidence of CMV Retinitis two Weeks after Initiation of Art

Cytomegalovirus (CMV) is a double-stranded DNA virus in the herpes virus family that can cause disseminated or localized endorgan disease in patients with advanced immunosuppression. Endorgan disease caused by CMV occurs in patients with advanced immunosuppression, typically those with CD4 T-lymphocyte cell (CD4) counts <50 cells/mm3, who are either not receiving or have failed to respond to antiretroviral therapy (ART). Cytomegalovirus (CMV) is found universally throughout all geographic and socioeconomic areas and infects an estimated 40%to 100% of adults by the fourth decade of life. 

In addition, almost all homosexual men with HIV are coinfected with CMV. In HIV-infected persons, CMV can infect the GI tract, liver, lung, and nervous system. CMV can also infect the retina and is the leading cause of blindness in the HIV population. The most common manifestation of CMV disease is CMV retinitis, which accounts for 85% of all cases of CMV clinical syndromes. GI disease is also a common manifestation, accounting for approximately 15% of cases, and includes esophagitis, colitis, gastritis, and hepatitis.  Read more........................