PROGRESSIVE ENCEPHALOPATHY ASSOCIATED WITH CYTOMEGALOVIRUS-INFECTION WITHOUT IMMUNE-DEFICIENCY

Slowly progressive encephalopathy caused by cytomegalovirus is an unus ual disorder, and its pathogenesis remains unknown except for cases as sociated with the acquired immune deficiency syndrome and organ transp lantation. We report a case who showed clinical features of progressiv e encephalopathy. Cytomegalovirus was repeatedly isolated from urine, and cytomegalovirus-infected cells were detected in bone marrow. Seria l computed tomographic head scan revealed periventricular calcificatio n and its progression to the thalamus, cerebellum, and brain stem. On autopsy, there were multiple calcifications and diffuse glial prolifer ation in the gray and white matter. Perivascular inflammation was only minimal. There was no evidence of immune deficiency. This case sugges ts that progressive encephalopathy can be caused by cytomegalovirus in fection without immune deficiency. This type of cytomegalovirus infect ion may be unusual, but its serious outcome should remind us to detect it accurately.