General Medicine, Kasturba Medical College Manipal, Manipal, Karnataka, India.
Department of Infectious Diseases, Kasturba Medical College Manipal, Manipal, Karnataka, India.
BMJ Case Rep. 2021 Mar 9;14(3):e240725. doi: 10.1136/bcr-2020-240725.
In patients with HIV infection, lower limb weakness is a result of the pathological involvement of the brain, spinal cord or peripheral nervous system. The pathological process can be opportunistic infections, nutrient deficiencies, neoplastic infiltration or HIV itself. Here, we present the case of a 50-year-old manual labourer who presented with gradually progressive lower limb weakness, sensory disturbances, impotence and urinary urgency. He was diagnosed with HIV during evaluation. Based on the presentation and other supportive laboratory and radiological evidence, the following differentials were considered: vacuolar myelopathy, amyotrophic lateral sclerosis and myeloradiculopathy. The patient was initiated on antiretroviral therapy, and he showed significant improvement of symptoms on follow-up. We report this case to discuss the diagnostic puzzle.
在 HIV 感染患者中，下肢无力是大脑、脊髓或周围神经系统病理性受累的结果。病理过程可能是机会性感染、营养缺乏、肿瘤浸润或 HIV 本身。在这里，我们介绍了一例 50 岁的体力劳动者，他逐渐出现下肢无力、感觉障碍、阳痿和尿急。在评估过程中被诊断为 HIV 感染。根据表现和其他支持性实验室和影像学证据，考虑了以下鉴别诊断：空泡性脊髓病、肌萎缩侧索硬化症和脊神经根炎。患者开始接受抗逆转录病毒治疗，随访时症状明显改善。我们报告这个病例是为了讨论诊断难题。
