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result sql = [Case of acute primary HIV infection with menigoencephalitis demonstrating high signal intensity of the bilateral globus pallidus in T2-weighted MRI].
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result sql = A slightly obtunded 59-year-old man admitted for headache and consciousness disturbance after two weeks of fever, sore throat, and general malaise. His cerebrospinal fluid showed a slight increase in the white cell count and protein content. T2-weighted MRI demonstrated high signal intensity of the bilateral globus pallidus. Cerebrospinal fluid culture was negative for fungi and bacteria, including mycobacterium tuberculosis. Negative results for PCR and ELISA made herpes simplex virus encephalitis unlikely. We treated him empirically with aciclovir and cefpirome, conducting further tests because a HIV serological test was positive on admission HIV RNA : was 2.9 x 10(5) copies/ml in the blood. Western blot analysis demonstrated positive bands at gp160, p24, p55, and p68, but negative at gp120, p52, gp41, p40, p34, and p18. These results yielded a definitive diagnosis of acute primary HIV infection presenting as meningoencephalitis. His clinical condition improved over the next few days. Repeated MRI showed a new lesion in the pons on T2-weighted images. No MRI abnormality has reported previously in acute primary HIV infection with meningoencephalitis. High signal intensity in the bilateral globus pallidus and the pons in patients with meningoencephalitis may thus be a useful indicator for acute primary HIV infection.
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result sql = [Case of acute primary HIV infection with menigoencephalitis demonstrating high signal intensity of the bilateral globus pallidus in T2-weighted MRI].
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char = r;code = 114
char = e;code = 101
char = b;code = 98
char = r;code = 114
char = o;code = 111
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = f;code = 102
char = l;code = 108
char = u;code = 117
char = i;code = 105
char = d;code = 100
char = ;code = 32
char = s;code = 115
char = h;code = 104
char = o;code = 111
char = w;code = 119
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = s;code = 115
char = l;code = 108
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = h;code = 104
char = i;code = 105
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = e;code = 101
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = u;code = 117
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = t;code = 116
char = e;code = 101
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = 2;code = 50
char = -;code = 45
char = w;code = 119
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = M;code = 77
char = R;code = 82
char = I;code = 73
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = h;code = 104
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = ;code = 32
char = s;code = 115
char = i;code = 105
char = g;code = 103
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = b;code = 98
char = i;code = 105
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = g;code = 103
char = l;code = 108
char = o;code = 111
char = b;code = 98
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = i;code = 105
char = d;code = 100
char = u;code = 117
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = C;code = 67
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = b;code = 98
char = r;code = 114
char = o;code = 111
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = f;code = 102
char = l;code = 108
char = u;code = 117
char = i;code = 105
char = d;code = 100
char = ;code = 32
char = c;code = 99
char = u;code = 117
char = l;code = 108
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = n;code = 110
char = e;code = 101
char = g;code = 103
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = f;code = 102
char = u;code = 117
char = n;code = 110
char = g;code = 103
char = i;code = 105
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = a;code = 97
char = ,;code = 44
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = l;code = 108
char = u;code = 117
char = d;code = 100
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = m;code = 109
char = y;code = 121
char = c;code = 99
char = o;code = 111
char = b;code = 98
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = u;code = 117
char = m;code = 109
char = ;code = 32
char = t;code = 116
char = u;code = 117
char = b;code = 98
char = e;code = 101
char = r;code = 114
char = c;code = 99
char = u;code = 117
char = l;code = 108
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = N;code = 78
char = e;code = 101
char = g;code = 103
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = u;code = 117
char = l;code = 108
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = f;code = 102
char = o;code = 111
char = r;code = 114
char = ;code = 32
char = P;code = 80
char = C;code = 67
char = R;code = 82
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = E;code = 69
char = L;code = 76
char = I;code = 73
char = S;code = 83
char = A;code = 65
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = d;code = 100
char = e;code = 101
char = ;code = 32
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = p;code = 112
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = s;code = 115
char = i;code = 105
char = m;code = 109
char = p;code = 112
char = l;code = 108
char = e;code = 101
char = x;code = 120
char = ;code = 32
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = p;code = 112
char = h;code = 104
char = a;code = 97
char = l;code = 108
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = u;code = 117
char = n;code = 110
char = l;code = 108
char = i;code = 105
char = k;code = 107
char = e;code = 101
char = l;code = 108
char = y;code = 121
char = .;code = 46
char = ;code = 32
char = W;code = 87
char = e;code = 101
char = ;code = 32
char = t;code = 116
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = h;code = 104
char = i;code = 105
char = m;code = 109
char = ;code = 32
char = e;code = 101
char = m;code = 109
char = p;code = 112
char = i;code = 105
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = a;code = 97
char = c;code = 99
char = i;code = 105
char = c;code = 99
char = l;code = 108
char = o;code = 111
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = c;code = 99
char = e;code = 101
char = f;code = 102
char = p;code = 112
char = i;code = 105
char = r;code = 114
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = ,;code = 44
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = d;code = 100
char = u;code = 117
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = f;code = 102
char = u;code = 117
char = r;code = 114
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = t;code = 116
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = b;code = 98
char = e;code = 101
char = c;code = 99
char = a;code = 97
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = H;code = 72
char = I;code = 73
char = V;code = 86
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = t;code = 116
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = p;code = 112
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = d;code = 100
char = m;code = 109
char = i;code = 105
char = s;code = 115
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = ;code = 32
char = H;code = 72
char = I;code = 73
char = V;code = 86
char = ;code = 32
char = R;code = 82
char = N;code = 78
char = A;code = 65
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = 2;code = 50
char = .;code = 46
char = 9;code = 57
char = ;code = 32
char = x;code = 120
char = ;code = 32
char = 1;code = 49
char = 0;code = 48
char = (;code = 40
char = 5;code = 53
char = );code = 41
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = p;code = 112
char = i;code = 105
char = e;code = 101
char = s;code = 115
char = /;code = 47
char = m;code = 109
char = l;code = 108
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = b;code = 98
char = l;code = 108
char = o;code = 111
char = o;code = 111
char = d;code = 100
char = .;code = 46
char = ;code = 32
char = W;code = 87
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = n;code = 110
char = ;code = 32
char = b;code = 98
char = l;code = 108
char = o;code = 111
char = t;code = 116
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = y;code = 121
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = b;code = 98
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = g;code = 103
char = p;code = 112
char = 1;code = 49
char = 6;code = 54
char = 0;code = 48
char = ,;code = 44
char = ;code = 32
char = p;code = 112
char = 2;code = 50
char = 4;code = 52
char = ,;code = 44
char = ;code = 32
char = p;code = 112
char = 5;code = 53
char = 5;code = 53
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = 6;code = 54
char = 8;code = 56
char = ,;code = 44
char = ;code = 32
char = b;code = 98
char = u;code = 117
char = t;code = 116
char = ;code = 32
char = n;code = 110
char = e;code = 101
char = g;code = 103
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = g;code = 103
char = p;code = 112
char = 1;code = 49
char = 2;code = 50
char = 0;code = 48
char = ,;code = 44
char = ;code = 32
char = p;code = 112
char = 5;code = 53
char = 2;code = 50
char = ,;code = 44
char = ;code = 32
char = g;code = 103
char = p;code = 112
char = 4;code = 52
char = 1;code = 49
char = ,;code = 44
char = ;code = 32
char = p;code = 112
char = 4;code = 52
char = 0;code = 48
char = ,;code = 44
char = ;code = 32
char = p;code = 112
char = 3;code = 51
char = 4;code = 52
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = p;code = 112
char = 1;code = 49
char = 8;code = 56
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = u;code = 117
char = l;code = 108
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = y;code = 121
char = i;code = 105
char = e;code = 101
char = l;code = 108
char = d;code = 100
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = f;code = 102
char = i;code = 105
char = n;code = 110
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = a;code = 97
char = g;code = 103
char = n;code = 110
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = a;code = 97
char = c;code = 99
char = u;code = 117
char = t;code = 116
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = i;code = 105
char = m;code = 109
char = a;code = 97
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = H;code = 72
char = I;code = 73
char = V;code = 86
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = f;code = 102
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = o;code = 111
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = p;code = 112
char = h;code = 104
char = a;code = 97
char = l;code = 108
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = H;code = 72
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = c;code = 99
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = d;code = 100
char = i;code = 105
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = i;code = 105
char = m;code = 109
char = p;code = 112
char = r;code = 114
char = o;code = 111
char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = n;code = 110
char = e;code = 101
char = x;code = 120
char = t;code = 116
char = ;code = 32
char = f;code = 102
char = e;code = 101
char = w;code = 119
char = ;code = 32
char = d;code = 100
char = a;code = 97
char = y;code = 121
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = R;code = 82
char = e;code = 101
char = p;code = 112
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = M;code = 77
char = R;code = 82
char = I;code = 73
char = ;code = 32
char = s;code = 115
char = h;code = 104
char = o;code = 111
char = w;code = 119
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = ;code = 32
char = n;code = 110
char = e;code = 101
char = w;code = 119
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = T;code = 84
char = 2;code = 50
char = -;code = 45
char = w;code = 119
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = i;code = 105
char = m;code = 109
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = s;code = 115
char = .;code = 46
char = ;code = 32
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char = M;code = 77
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char = ;code = 32
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char = e;code = 101
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char = d;code = 100
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char = v;code = 118
char = i;code = 105
char = o;code = 111
char = u;code = 117
char = s;code = 115
char = l;code = 108
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char = i;code = 105
char = n;code = 110
char = ;code = 32
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char = e;code = 101
char = ;code = 32
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char = r;code = 114
char = i;code = 105
char = m;code = 109
char = a;code = 97
char = r;code = 114
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char = ;code = 32
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char = n;code = 110
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char = t;code = 116
char = h;code = 104
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char = i;code = 105
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char = ;code = 32
char = m;code = 109
char = a;code = 97
char = y;code = 121
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = u;code = 117
char = s;code = 115
char = ;code = 32
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char = e;code = 101
char = ;code = 32
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char = ;code = 32
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = f;code = 102
char = u;code = 117
char = l;code = 108
char = ;code = 32
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char = d;code = 100
char = i;code = 105
char = c;code = 99
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char = o;code = 111
char = r;code = 114
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char = ;code = 32
char = i;code = 105
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char = f;code = 102
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = i;code = 105
char = o;code = 111
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result sql = A slightly obtunded 59-year-old man admitted for headache and consciousness disturbance after two weeks of fever, sore throat, and general malaise. His cerebrospinal fluid showed a slight increase in the white cell count and protein content. T2-weighted MRI demonstrated high signal intensity of the bilateral globus pallidus. Cerebrospinal fluid culture was negative for fungi and bacteria, including mycobacterium tuberculosis. Negative results for PCR and ELISA made herpes simplex virus encephalitis unlikely. We treated him empirically with aciclovir and cefpirome, conducting further tests because a HIV serological test was positive on admission HIV RNA : was 2.9 x 10(5) copies/ml in the blood. Western blot analysis demonstrated positive bands at gp160, p24, p55, and p68, but negative at gp120, p52, gp41, p40, p34, and p18. These results yielded a definitive diagnosis of acute primary HIV infection presenting as meningoencephalitis. His clinical condition improved over the next few days. Repeated MRI showed a new lesion in the pons on T2-weighted images. No MRI abnormality has reported previously in acute primary HIV infection with meningoencephalitis. High signal intensity in the bilateral globus pallidus and the pons in patients with meningoencephalitis may thus be a useful indicator for acute primary HIV infection.
Publication: Rinsho Shinkeigaku 2007 Sep ;47(9)::597-600.
Publication Date: 2007 Sep
Study Author(s): Yoshizawa, Toshihiro;Motonishi, Shuta;Saitoh, Masaaki;
Institution: Department of Neurology, Kanto Medical Center NTT EC.
Shortcut link to this study:
Publication Date: 2007 Sep
Study Author(s): Yoshizawa, Toshihiro;Motonishi, Shuta;Saitoh, Masaaki;
Institution: Department of Neurology, Kanto Medical Center NTT EC.
Shortcut link to this study:
A slightly obtunded 59-year-old man admitted for headache and consciousness disturbance after two weeks of fever, sore throat, and general malaise. His cerebrospinal fluid showed a slight increase in the white cell count and protein content. T2-weighted MRI demonstrated high signal intensity of the bilateral globus pallidus. Cerebrospinal fluid culture was negative for fungi and bacteria, including mycobacterium tuberculosis. Negative results for PCR and ELISA made herpes simplex virus encephalitis unlikely. We treated him empirically with aciclovir and cefpirome, conducting further tests because a HIV serological test was positive on admission HIV RNA : was 2.9 x 10(5) copies/ml in the blood. Western blot analysis demonstrated positive bands at gp160, p24, p55, and p68, but negative at gp120, p52, gp41, p40, p34, and p18. These results yielded a definitive diagnosis of acute primary HIV infection presenting as meningoencephalitis. His clinical condition improved over the next few days. Repeated MRI showed a new lesion in the pons on T2-weighted images. No MRI abnormality has reported previously in acute primary HIV infection with meningoencephalitis. High signal intensity in the bilateral globus pallidus and the pons in patients with meningoencephalitis may thus be a useful indicator for acute primary HIV infection.
PMID: 18018620
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