Acute encephalitis as initial presentation of primary HIV infection

Abstract

Acute encephalitis is a life-threatening condition. A wide variety of infectious agents are implicated and in many patients no cause is found. HIV acute seroconversion illness can rarely present as acute encephalitis. Although most experts agree in starting antiretroviral treatment in severe acute HIV infection, the evidence of the benefits are still lacking. The authors report a case of severe acute encephalitis as a primary presentation of HIV infection in which introduction of highly active antiretroviral treatment resulted in clinical recovery. This case highlights the need to consider HIV infection in the differential diagnosis of treatable viral encephalitis.

Acute retroviral syndrome presenting as encephalitis and cerebellar ataxia: case report and literature review

“…El SRA con encefalitis es un cuadro raro. En 2012, se describió el caso de un paciente previamente sano que tuvo deterioro progresivo de la consciencia y en quien la presencia de candidiasis oral y plaquetopenia oscura llevó a evaluar VIH como etiología de encefalitis, el cual resultó como diagnóstico final (8). Este paciente mejoró su compromiso al iniciar terapia antirretroviral, a diferencia del paciente que hemos descrito en este caso, en quien el cuadro fue autolimitado.…”

Infectious encephalitis: Management without etiological diagnosis 48 hours after onset

“…The authors of a study of 23 patients presenting with HIV primary infection and neurological damage observed that 13 patients (57%) had peripheral neuropathy, eight (35%) had isolated lymphocytic meningitis, and two (9%) had acute encephalitis [84]. Reported central neurological damages included encephalitis [85][86][87][88] and ADEM [89], which were sometimes life-threatening [90,91]. Patients presenting with neurological symptoms at the primary infection stage seemed to contract AIDS more rapidly [84].…”