Clinical case of diagnosis of final stage of HIV infection in a teenager with chorea

Abstract

HIV infection is rarely considered a possible etiological factor of neurological pathology, that causes the late diagnosis of the disease and the untimely start of a specific therapy. The neurological manifestations of the disease may be due to the direct impact of HIV on the nervous system, opportunistic infections and malignancies, neurotoxic effects of antiretroviral treatment, and other systemic complications. HIV-associated neurological disorders are variable and presented with neurocognitive disorders, encephalopathy, myelopathy, polyneuropathy, aseptic meningitis (meningoencephalitis). HIV-encephalopathy in children manifests with emotional, cognitive, motor and speech disorders. In adults, chorea syndrome is considered a possible clinical variant of HIV encephalopathy. In the literature available, we have not encountered reports about the development of choroid syndrome in HIV-infected children. The described clinical case demonstrates the diagnosis of late-stage HIV infection in a 13-year-old child with chorea syndrome. The presented clinical observation demonstrates the complexity of diagnosing HIV encephalopathy in a child, which has been associated with the rare manifestation of this disease in childhood as generalized hyperkinesis, as well as the concealment of anamnestic HIV infection in a mother. Thus, in children with chorea, the diagnosis is possible only with the exclusion of the diseases that cause it, namely: acute rheumatic fever, systemic connective tissue disease, demyelinating diseases, tumours of the central nervous system, Wilson-Konovalov disease, as well as HIV.

Keywords

• hiv infection
• hiv encephalopathy
• сhorea
• children