Central Nervous System Involvement in a Child with Human Immunodeficiency Virus Infection: A Case Report

HIV has infected 4.4 million children worldwide and has resulted in 3.2 million deaths. The progression of vertically acquired HIV infection appears to have a trimodal distribution. Approximately, 15% of children have rapidly progressive type of disease, while the remainders have either a chronic progressive course or an infectious pattern typical of that in adults. Mean survival is about 10 years. Children can be asymptomatic for many years, and the appearance of an opportunistic infection in a 10-year-old child in whom AIDS is subsequently diagnosed is not rare. Neurologic findings in an infected child are: Motor delay, hypotonia, hypertonia, and/or pyramidal tract signs which may indicate progressive HIV encephalopathy or opportunisic infection of the CNS. Our case was an 8-year old boy presented with fever, vomiting, and loss of consciousness.The patient was a known case of HIV infection due to mother’s infection in perinatal period and was on treatment from 3 years before his referral. He was presented to our hospital for the fever which had started one month earlier and refractory vomiting. The patient got in coma on the chest examination; tachypnea, crackles and heart murmur were auscultated. In neurologic examination, anisocoria, right-sided hemiparesis, increased deep tendon reflexes in the right side and extensor plantar reflex, Kernig and Brudzinski signs were detected. Eventually, the patient died after 46 days of hospitalization in pediatric intensive care unit because of full sepsis.