Pharyngeal-brachial palsy after cytomegalovirus colitis
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Cytomegalovirus (CMV) is known to be associated with various central and peripheral neurologic disorders in patients with AIDS or after bone marrow or solid organ transplantation.1 We report a patient with acute pharyngeal and brachial palsy after CMV colitis following bone marrow transplantation. This is the first report of regional neuropathy in a patient with CMV colitis.
Case report.
A 37-year-old woman developed acute onset of progressive dysarthria, dysphagia, and distal weakness of bilateral upper extremities. She had chronic myeloid leukemia and received bone marrow transplantation. Two months later, she developed intractable watery diarrhea and pancytopenia. Stool cultures for common intestinal pathogens, including Campylobacter jejuni, were negative. Colonic biopsy showed swelling of mucosal epithelium with nuclear inclusion bodies with immunohistochemical evidence of CMV. Serum PCR for CMV was also positive. She was treated with anti-CMV immunoglobulins (Ig) (100 mg/kg/day three times per week) and ganciclovir (5 mg/kg/day twice a week). The diarrhea stopped and the serum CMV-PCR …
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