Cytomegalovirus meningoencephalitis in an immunocompetent host with evolution of cystic encephalomalacia

dc.contributor.authorMiller, Derryl J.
dc.contributor.authorDavis, Jade
dc.contributor.authorGervelis, Whitney
dc.contributor.authorSinghal, Saurabh
dc.contributor.authorConrad, Susan
dc.contributor.departmentNeurology, School of Medicine
dc.date.accessioned2025-07-16T11:33:38Z
dc.date.available2025-07-16T11:33:38Z
dc.date.issued2025-05-12
dc.description.abstractA previously healthy 2-month-old male presented with fever and seizures. Cerebrospinal fluid (CSF) studies, head computed tomography (CT), and brain magnetic resonance imaging (MRI) studies were unremarkable on admission. After a clinical decline on the second day admission due to cerebral edema a repeat head CT showed loss of gray-white matter differentiation indicative of global anoxic injury. A repeat brain MRI on day 5 revealed diffuse restricted diffusion globally, acute infarction of the right posterior inferior cerebellar artery territory, and left frontoparietal leptomeningitis versus cortical laminar necrosis. A repeat LP was done on day 5 and showed a total nucleated cell count of 42 cells/mm^3 with 39% lymphocytes and 61% monocytes, glucose 52 mg/dL. He made steady clinical improvement with supportive care. CMV was detected on the repeat CSF sample using PCR on day 11 and he was started on ganciclovir for CMV meningoencephalitis. CMV should be considered as an etiology for viral meningoencephalitis even in immunocompetent patients. Our case also shows the classic imaging evolution of CMV meningoencephalitis.
dc.eprint.versionFinal published version
dc.identifier.citationMiller DJ, Davis J, Gervelis W, Singhal S, Conrad S. Cytomegalovirus meningoencephalitis in an immunocompetent host with evolution of cystic encephalomalacia. Radiol Case Rep. 2025;20(8):3689-3692. Published 2025 May 12. doi:10.1016/j.radcr.2025.04.053
dc.identifier.urihttps://hdl.handle.net/1805/49506
dc.language.isoen_US
dc.publisherElsevier
dc.relation.isversionof10.1016/j.radcr.2025.04.053
dc.relation.journalRadiology Case Reports
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourcePMC
dc.subjectMeningoencephalitis
dc.subjectCytomegalovirus
dc.subjectCystic encephalomalacia
dc.subjectMagnetic resonance imaging
dc.subjectComputed tomography
dc.subjectDrug resistant epilepsy
dc.titleCytomegalovirus meningoencephalitis in an immunocompetent host with evolution of cystic encephalomalacia
dc.typeArticle
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