Cytomegalovirus infection presenting with low cranial nerve palsy

초록

background & Significance : Cytomegalovirus(CMV) is a viral genus of the viral family known as herpesviruses. Although they may be found throughout the body, CMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised patients. Diagnosis is usually done histologically by finding the inclusion bodies in infected tissue. We experienced one unusual case of CMV infection involving the multiple cranial nerves. Case : A 55-year old man had severe left eyeball pain, three months before admission. He then presented with throat pain, dysarthria and severe dysphagia with dehydration. On admission, neurological examination showed left seventh, ninth, tenth and twelfth nerve palsies with severe pain on occipital area. He had the uncontrolled diabetes mellitus and chronic otitis media. The CSF test revealed increase in white cell counts compatible with viral meningitis. HIV Antigen test and Brain MRI/A were negative. The initial diagnosis was herpes occipitocollaris. After treatment of steroid and acyclovir, the low cranial nerve palsy.