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The peripheral nervous system is the most commonly affected part of the neuraxis in HIV-infected individuals.1 Mononeuropathies in HIV infection are an uncommon form of peripheral neuropathy presenting in most cases as facial palsy or wrist or foot drop. We report a patient with diaphragmatic paralysis caused by bilateral phrenic neuropathy.
Case report.
A 46-year-old man with an 11-year history of HIV infection sought treatment in June 2001 for a 1-week history of dyspnea on lying down. He had a CD4 count of 250 cells/mm3 and a viral load <50 copies/mL while taking zidovudine, lamivudine, and nelfinavir since November 1998. There was no history of diabetes, and serum glucose was normal. His dyspnea began within days of completing an outdoor construction project, during which he had mild trauma to his right hand with subsequent weakness and pain in that hand. He noted that he could not burp or sniff. Chest radiography revealed bilateral atelectatic changes at the bases, …
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