Table 1 Timeline of the main clinical events
From: Transverse myelitis and acute HIV infection: a case report
PRIOR TO HOSPITAL ADMISSION | |
|---|---|
Week 1 | Travels to Angola. |
Week 4 | Uncomplicated malaria episode. |
Week 32 | Ear piercing. |
Week 34 | Probable gastroenteritis and arthropod bite. |
Week 35 | Fatigue, fever, myalgia, non-productive cough, thoracic pain (belt-like). |
Treated with antibiotics. | |
Week 40 | Persisting fatigue and thoracic pain. |
Returns to Portugal and seeks medical care. Discharged on analgesics. | |
HOSPITAL ADMISSION | |
Day 1 | Worsening fatigue and thoracic pain. |
Urinary retention, paraparesia and hypoaesthesia. | |
HIV screening positive, Inno-Lia™ indeterminate. | |
MRI suggestive of myelitis. | |
Ceftriaxone, gancyclovir and methylprednisolone. | |
Day 3 | Worsening neurologic symptoms. |
Mild CSF pleocytosis and protein elevation. | |
Doxycicline and human immunoglobulin. Stops gancyclovir. | |
Day 10 | Progressive and complete resolution of symptoms. |
HIV-1 RNA detection on blood and CSF. 760/mm3 T-CD4 count. | |
Day 21 | HIV screening positive, Inno-Lia™ indeterminate. |
Discharged home. | |
OUTPATIENT CLINIC | |
Month 3 | Assymptomatic. |
Inno-Lia™ positive. | |
Month 12 | Assymptomatic. |
Progressive decline of T-CD4 count to below 400/mm3. | |
Anti-retroviral therapy instituted. | |