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Ganciclovir in the treatment of progressive AIDS-related polyradiculopathy

Departments of Neurology and Pathology, Children's Hospital of San Francisco, and the University of California, San Francisco, CA.

We present 7 HIV-infected patients with a unique, subacute, progressive polyradiculopathy. All had AIDS, sacral sensory loss, acute urinary retention, and progression to flaccid paraparesis in days to weeks. Cytomegalovirus was cultured from spinal fluid of 4 patients, and postmortem examination on the 1st 5 patients disclosed an inflammatory polyradiculopathy with cytomegalic inclusions. The inclusion-bearing cells were immunocytochemically positive for cytomegalovirus. Two patients who received early anti-cytomegalovirus treatment with ganciclovir improved. Thus, early recognition and treatment with ganciclovir may be effective in this otherwise fatal condition.

Address correspondence and reprint requests to Dr. Robert G. Miller, 3700 California Street (OPR 613), San Francisco, CA 94118.

Received July 5, 1989. Accepted for publication in final form September 21, 1989.

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