Cytomegalovirus Meningoencephalitis in an Immunocompromised Patient: Case Report and Review of Literature

Abstract

Cytomegalovirus (CMV), is a common virus that stays dormant after the initial infection but can reactivate in immunocompromised individuals, such as those with AIDS, leading to severe conditions. CMV affects 30% to 100% of people worldwide. CMV encephalitis is seen in at least 6% of untreated advanced HIV cases. This article presents a 42-year-old HIV-positive woman who developed CMV meningoencephalitis, resulting in septic shock. CMV can cause cytomegalia and various diseases including pneumonia, gastrointestinal disease, hepatitis, and, rarely, retinitis and meningitis/meningoencephalitis. Diagnosis typically involves detecting CMV DNA in the cerebrospinal fluid (CSF) through PCR.CMV causes diverse central nervous system lesions, but MRI often fails to detect these infections, as seen in this case. Treatment involves Ganciclovir or Foscarnet, starting with induction doses for at least two weeks, followed by maintenance doses for three to four weeks until symptoms resolve and viral load is negative. In immunosuppressed patients, ongoing maintenance or close monitoring is necessary.