Akademik Veri Yönetim Sistemi
IZMIR DR BEHCET UZ COCUK HASTANESI DERGISI, cilt.5, sa.1, ss.69-74, 2015 (ESCI, TRDizin)
CMV infections leads to variable clinical conditions in patients with normal immune system and immunodeficiency. The ratio of symptomatic infection in patients with normal immunodeficiency is under 10 percent. Symptomatic patients generally present with mononucleosis-like syndrome, and rarely with organ specific complications involving central nervous system, respiratory system, gastrointestinal system, cardiovascular system, hepatic and hematologic system. Central nervous system infections of CMV are more common in patients with immunodeficiency and include encephalitis, ventriculoencephalitis, cerebral mass lesions, transverse myelitis and polyradiculomyelitis. Here, we present a previously healthy 4-year-old boy with CMV infection related diffuse encephalomyelitis because of its rare occurrence. A four-year-old boy was admitted with complaints of progressive weakness in lower extremities, decreased level of consciousness, irritability, urinary retention and constipation. Muscle power was decreased in proximal and distal muscles of legs and deep tendon reflexes could not be elicited in lower extremities. Anti-CMV IgM and IgG were positive and CMV avidity was in grey zone. CSF analysis revealed CMV, HSV1-2 DNA. negativity Brain and spinal cord MRI revealed hyperintense lesions. Gancyclovir and immunoglobulin treatments were started. Pulse methylprednisolone was then added to the treatment. The patient was taken into physical rehabilitation for weakness and intermittent catheterization was ordered for neurogenic bladder. In conclusion, CMV is one of the etiological factors of diffuse encephalomyelitis in children with normal immune system. Its diagnosis is challenging and depends on serologic, virologic, radiologic and clinical findings. More information is needed for the best treatment protocol of CMV-related neurologic disorders in patients with normal immune system.