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CNS Drugs

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01-05-2002 | Therapy In Practice

CNS Manifestations of Cytomegalovirus Infections

Diagnosis and Treatment

Authors: Matthias Maschke, Oliver Kastrup, Hans-Christoph Diener

Published in: CNS Drugs | Issue 5/2002

Abstract

Cytomegalovirus (CMV) infection of the CNS occurs most commonly in patients with severe immunosuppression such as those with advanced HIV infection (i.e. AIDS) or those who have undergone bone marrow or solid organ transplantation. Immunocompetent patients are affected very rarely. The infection of the CNS may affect the brain (diffuse encephalitis, ventriculoencephalitis, cerebral mass lesions) or the spinal cord (transverse myelitis, polyradiculomyelitis). Diagnosis is very difficult and should be based on clinical presentation, results of imaging and virological markers. The most specific diagnostic tool is the detection of CMV DNA by polymerase chain reaction in the CSF. Treatment should be initiated promptly if CMV infection is suspected. Antiviral therapy consists of intravenous ganciclovir, intravenous foscarnet or a combination of both. Cidofovir is the treatment of second choice. Patients who experience clinical improvement or stabilisation during induction therapy should be given maintenance therapy. After immune reconstitution (in HIV-positive patients) or discontinuation of immunosuppressive therapy (in transplant recipients), maintenance therapy may be stopped. Despite therapy, the prognosis for long-term survival is very poor, especially in patients with AIDS.

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Title: CNS Manifestations of Cytomegalovirus Infections
Diagnosis and Treatment
Authors: Matthias Maschke
Oliver Kastrup
Hans-Christoph Diener
Publication date: 01-05-2002
Publisher: Springer International Publishing
Published in: CNS Drugs / Issue 5/2002
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI: https://doi.org/10.2165/00023210-200216050-00003

Keynote webinar | Spotlight on medication adherence

Springer Medicine

CNS Manifestations of Cytomegalovirus Infections

Diagnosis and Treatment

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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