Neurological Manifestations of Congenital Cytomegalovirus Infection at a Tertiary Care Centre from Southern India

Abstract Background Cytomegalovirus (CMV) is a ubiquitous herpes virus. It is the most common congenital viral infection. Data on congenital CMV in India are lacking and hence the present study was undertaken. Objectives The aim of the study is to evaluate the clinical and radiological profile of neurological manifestations of congenital CMV infections in tertiary care hospital. Methods This is a retrospective chart review of the clinical and laboratory profile of congenital CMV infections presenting from January 2018 to February 2020 to a tertiary care hospital in Southern India. Details of clinical profile, serological and neuroimaging data were obtained and analyzed. Results A total of 42 cases with female preponderance (57%) were reported during the study period. The mean age of presentation was 2.9 years. Clinical features were developmental delay (81%), microcephaly (93%), seizures (33%), intrauterine growth restriction (19%), neonatal encephalopathy (10%), anemia (9%), jaundice (10%), hepato-splenomegaly (7%), and eye abnormalities (14%). Antenatal maternal fever was reported by 12%. Sensorineural hearing loss was present in 57%. Neuroimaging showed periventricular calcification (79%), cerebral atrophy (69%), ventricular dilatation (55%), malformations (26%), dysmyelination (12%), and temporal lobe cysts (5%). CMV-immunoglobulin-M positivity was seen in 14 cases (33%), urinary polymerase chain reaction for CMV was positive in 21 cases (50%), and clinical diagnosis was done in seven cases (16%). Conclusion Common findings in congenital CMV are microcephaly, developmental delay, seizures, anemia, and sensorineural hearing loss. Common neuroimaging findings are periventricular calcification, cerebral atrophy, malformation, white matter signal changes, and cysts. CMV can mimic like cerebral palsy, malformations of the brain, demyelinating disorders, and calcified leukoencephalopathies like Aicardi-Goutières syndrome.

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Sudden sensorineural hearing loss in adults - Our experience with a multidrug high-dose steroid regimen at a tertiary care hospital

The Egyptian Journal of Otolaryngology ◽

10.4103/1012-5574.181085 ◽

2016 ◽

Vol 32 (2) ◽

pp. 105

Author(s):

Abhineet Jain ◽

Vivek Gupta ◽

PraveerK Banerjee ◽

Sonam Rathi

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Sudden Sensorineural Hearing Loss ◽

Sensorineural Hearing ◽

High Dose ◽

Care Hospital ◽

High Dose Steroid ◽

Steroid Regimen

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A study on clinical profile of neurological manifestations among HIV infected patients attending a tertiary care hospital of south India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20184685 ◽

2018 ◽

Vol 5 (6) ◽

pp. 1392

Author(s):

Chandra Sekara Reddy Munamala ◽

Ramesh Babu Pannem

Keyword(s):

Cryptococcal Meningitis ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Clinical Signs ◽

Cerebral Atrophy ◽

Care Hospital ◽

Neurological Manifestations ◽

Tubercular Meningitis ◽

Meningeal Enhancement ◽

Cd4 Counts

Background: Current statistics show that 36.9 million (31.1-43.9 million) people were living with HIV globally at the end of 2017. 15-73% of people with HIV may develop neurological disorders with sometimes as a presenting illness. The aim of present study is to document the various neurological manifestations and presentations with relation to CD4 counts among the HIV/AIDS cases attending a tertiary care hospital of south India.Methods: A prospective study was conducted for two years at a tertiary care hospital among confirmed cases of HIV and the neurological manifestations were diagnosed and clinical signs and symptoms were noted. CD4 counts of all the cases were performed by FACS counter and Neuroimaging study was performed on necessary cases.Results: Total of 125 cases with 69.6% males and 30.4% females were enrolled. Mean age of cases was 35.14±3.8years. 86.4% were positive for HIV-1 type. Headache was the most common ailment (78.4%). Meningeal enhancement observed in 24.5% followed in order by ring enhancing lesion (18.37%), cerebral atrophy and infarction (12.24%). Tubercular meningitis was the commonest type (33.6%). In 12 cases of cryptococcal meningitis the CD4 counts were <100 cells/mm3.Conclusions: To conclude in present study, secondary neurological manifestations were more common than primary manifestations in present study. Tubercular meningitis being the most common and CD4 counts <100cells/mm3 were associated with cryptococcal meningitis. Cases with CD4 counts less than 100cells/mm3 had poor prognosis.

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