neuroplex
New York Association of Neuropathologists
10/21/2008 Case 3: CMV radiculopathy/multiple cranial neuritis/ventriculo-encephalitis/retinitis, and HIV encephalitis
Presented by: Dr. Ehud Lavi - New York Presbyterian Hospital
Clinical History:
A 36-year-old man with decreased visual acuity, back pain, bilateral radicular pain, fever
of 102°F, and known positive for HN. He was dysarthric and dysphagic, he had acute and
chronic retinitis, and multiple cranial nerves showed clinical involvement. Gait was unsteady.
Radiology revealed signal intensities around the 4th ventricle and multiple thickened cranial
nerves. He died of aspiration during a procedure to investigate dysphagia. Autopsy showed the
thickened cranial nerves, which were sectioned individually. The characteristic inclusions of
cytomegalovirus were found in the cranial nerves and in periventricular regions. Findings of HN
encephalitis were also present.
Diagnostic Notes:
CMV radiculopathy, CMV multiple cranial neuritis, CMV ventriculo-encephalitis,
HN encephalitis, and CMV retinitis.
