ENCEPHALOPATHY AND CYTOMEGALOVIRUS COLITIS IN AN AIDS CHILD

A 2-year-old girl, who had prolonged thrush and spastic diplegia, was found to have a mother-to-child vertical transmission of human immunod eficiency virus type-1 (HIV). A brain computed tomography scan reveale d a symmetrical calcification on the bilateral basal ganglia and periv entricular white matter. She had an acquired immune deficiency syndrom e (AIDS) encephalopathy of pure dominant pyramidal tract disorder with out an intellectual deficit. Helper cell lymphocyte count (CD4) increa sed with the beginning of zidovudine (ZDV, also known as AZT) monother apy but began to decrease after the 4th week to reach the baseline at 20th week. Zidovudine plus didanosine combination therapy was started at the 68th week, but because of intolerance, the combination was chan ged to ZDV plus lamivudine at the 98th week. By the 80th week, neither severe opportunistic infection nor deterioration of the neurological status was recognized, but chronic diarrhea appeared. The diarrhea adv anced to the wasting syndrome at the age of 4 years and cytomegaloviru s genome was confirmed in a biopsied specimen of the colon. Ganciclovi r treatment was effective in stopping the diarrhea and increasing her bodyweight, but after the age of 5, resumption of diarrhea was followe d by progressive emaciation and weakness. This work may provide some c lues in treating children's AIDS.