2011, Number 2
Rev Med MD 2011; 2.3 (2)
Castañeda-Castañeda DF, Morales-Villarreal MA
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ABSTRACTA 46-years-old female, with a diagnosis of infection by Human Immunodeficiency Virus (HIV) in 1999, displays virologic failure in 2005 initiating scheme with emtricitabine/tenofovir + darunavir/ritonavir, achieving virological suppression and immunologic reconstitution. In May of 2008 presents memory alteration, walk deviation, dysarthria, VI pair cranial complain and central origin facial paralysis, dysdiadochokinesia, and difficulty to hold objects with left hand. A Cranium Magnetic Resonance Imaging (MRI) with gadolinium was done, where lesions on cerebral sub-cortical nodes, perilesional edema and periventricular demyelinating are observed. The viral panel on cerebrospinal fluid and serum tested positive for parvovirus B19 (BP19). It is associated with late immune reconstitution inflammatory syndrome (IRIS) secondary to infection by BP19, therefore 3 immunoglobulin intravenous therapy cycles are received, subsiding the symptomatology gradually. The BP19 is a virus of single chain DNA. Two ways of presentation of infection by BP19 on patients with HIV have been described, one as exantematic disease on patients with HIV without AIDS and another on patients with HIV/AIDS as a persistent infection and chronic viremia, causing transitory inhibition of the erythropoiesis. It has been reported cases with neurological manifestations such as encephalitis, meningitis, cerebrovascular accident, peripheral neuropathy and epileptic status. Moreover, it is commonly associated to chronic fatigue syndrome.