HIV positive adult patient with very low CD 4+ count presents wtih altered conscious state.
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MRI demonstrates numerous periventricular high T2 signal regions which restrict on DWI. The additional high signal on T2 and DWI is seen lining the ependymal surface of the lateral ventricles, which also demonstrates faint enhancement.
Finding are consistent with CMV infection.
The patient went on to have a vitreous biopsy and lumbar punction. CSF was positive for CMV on PCR and positive culture of CMV from vitreous biopsy.
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