alexa Cytomegalovirus-Varicella Zoster Meningoencephalitis And Ischemic Stroke In An HIV-AIDS Patient: A Case Report
ISSN: 2332-0877

Journal of Infectious Diseases & Therapy
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Share This Page

Additional Info

Loading Please wait..

4th International Congress on Infectious Diseases
May 11-12, 2017 Barcelona, Spain

Monica Pia P Reyes and Ryan M Llorin
St. Luke’s Medical Center Global City, Philippines
Posters & Accepted Abstracts: J Infect Dis Ther
DOI: 10.4172/2332-0877-C1-024
Along with the increasing number of newly diagnosed Human Immunodeficiency Virus (HIV) patients per day in the Philippines (26 new cases/day), an increasing number of HIV patients were diagnosed with Central Nervous System Infection (CNSI) and Stroke. A study shows that the risk of ischemic stroke was higher among those with HIV infection compared with uninfected people (hazard ratio 1.17). Mechanisms of ischemic stroke include HIV-associated vasculopathy, opportunistic infections or neoplasia, cardioembolism and coagulopathy. This case report aims to present a CNS co-infection of the three most documented viruses that causes stroke: Cytomegalovirus (CMV), Varicella Zoster Virus (VZV) and HIV. The inflammatory cascade in these infections promotes atherosclerosis, plaque rupture, and thrombosis, leading to ischaemic stroke. A 35-year-old male with HIV who was noncompliant with anti-retroviral therapy and who had recent untreated shingles was brought in with decreased sensorium, signs of meningeal irritation and right-sided neurologic deficit. Computed tomography scan revealed acute to sub-acute infarct, left middle cerebral artery territory (figure 1). Vancomycin, ampicillin, cefepime and ganciclovir were empirically started for central nervous system infection. HIV work-up revealed a CD4 of 11 cells/mm3 and HIV-1 RNA of 1,124,215 copies/mL. CMV IgG was positive at 65 U/mL. Lumbar tap done had an elevated opening pressure with elevated cerebrospinal fluid (CSF) protein, low-normal CSF glucose, and pleocytosis with lymphocytic predominance. Viral panel showed CMV viral load of 634,000 copies/mL and VZV IgG 44.4mIU/L clinching the diagnosis of concomitant CMV-VZV meningoencephalitis in an HIV patient. Magnetic resonance imaging and angiogram is compatible with viral vasculopathy (figure 2). The pathogenic mechanisms of VZV reactivation in the CNS include neuronal and glial direct infection and immune-mediated lesions including vasculitis and demyelinization while CMV infection of vascular smooth muscle cells induces production of powerful pro-inflammatory cytokines which accelerate atherosclerosis development. This seems to be the first reported case of co-infection of the CMV-VZV-HIV meningoencephalitis and ischemic stroke.

Monica Pia P Reyes is a Diplomate of Philippine College of Physicians. She completed her Medical degree at University of the Philippines and; Internal Medicine Residency training at St. Luke’s Medical Center- Global City, Philippines where she was granted 2016 Excellence in Research Award. She is an incoming Infectious Disease Fellow at Philippine General Hospital. She has organized research forums and training workshops. Her research interest includes HIV/AIDS, Tuberculosis, and Critical Care Medicine.

Email: [email protected]

image PDF   |   image HTML

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals


[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

environmentalsc[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version