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Case Reports
. 2021 Mar 9;14(3):e240725.
doi: 10.1136/bcr-2020-240725.

Paraparesis in a patient with advanced HIV infection: a diagnostic conundrum

Anupa John  1 , Nitin Gupta  2   3 , Kavitha Saravu  4   3
Affiliations
Case Reports

Paraparesis in a patient with advanced HIV infection: a diagnostic conundrum

Anupa John et al. BMJ Case Rep. .

Abstract

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.

Keywords: HIV / AIDS; infection (neurology); motor neurone disease; spinal cord; tropical medicine (infectious disease).

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
T2-weighted images on sagittal section showing normal morphology and signal intensity of the spinal cord.
See this image and copyright information in PMC

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