Evidence map›Paper›PMID 27268102›Full record

ReviewJournal of medical case reports2016

Differential diagnosis and treatment of acute cauda equina syndrome in the human immunodeficiency virus positive patient: a case report and review of the literature.

George Panos, Dionysios C Watson, Ioannis Karydis, Dimitrios Velissaris, Marina Andreou, Vasilis Karamouzos, Maria Sargianou, Antonios Masdrakis, Paraskevi Chra, Lavrentios Roussos

Open access · goldAbstract readCase ReportsReview
In one paragraph

Review in Journal of medical case reports, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 9 citations in OpenAlex.

  1. When infection mimics cauda equina syndrome: a cautionary tale.Annals of the Royal College of Surgeons of England · 2021
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

George PanosSpecial Infections Unit, 2nd Internal Medicine Clinic, 1st Ι.Κ.Α. Penteli General Hospital, Melissia, Athens, Greece. george.panos@upatras.gr.
Dionysios C WatsonDepartment of Infectious Diseases, Patras University General Hospital, 26504, Rion, Patras, Greece.
Ioannis KarydisSpecial Infections Unit, 2nd Internal Medicine Clinic, 1st Ι.Κ.Α. Penteli General Hospital, Melissia, Athens, Greece.
Dimitrios VelissarisInternal Medicine Department, University Hospital of Patras, 26504, Rion, Patras, Greece.
Marina AndreouInternal Medicine Department, University Hospital of Patras, 26504, Rion, Patras, Greece.
Vasilis KaramouzosInternal Medicine Department, University Hospital of Patras, 26504, Rion, Patras, Greece.
Maria SargianouDepartment of Infectious Diseases, Patras University General Hospital, 26504, Rion, Patras, Greece.
Antonios MasdrakisSpecial Infections Unit, 2nd Internal Medicine Clinic, 1st Ι.Κ.Α. Penteli General Hospital, Melissia, Athens, Greece.
Paraskevi ChraDepartment of Microbiology, Benakio-Korgialenio Hospital, 1 Erythrou Staurou Street, 11526, Athens, Greece.
Lavrentios RoussosNeurosurgery Clinic, Κ.Α.Τ. Hospital, 2 Nikis Street, 14561, Kifissia, Athens, Greece.
General University Hospital of Patras · GRPenteli General Children's Hospital · GRGeneral Hospital of Attica · GRHellenic Red Cross · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute cauda equina syndrome is an uncommon but significant neurologic presentation due to a variety of underlying diseases. Anatomical compression of nerve roots, usually by a lumbar disk hernia is a common cause in the general population, while inflammatory, neoplastic, and ischemic causes have also been recognized. Among human immunodeficiency virus (HIV) infected patients with acquired immunodeficiency syndrome, infectious causes are encountered more frequently, the most prevalent of which are: cytomegalovirus, herpes simplex virus 1/2, varicella zoster virus, and Mycobacterium tuberculosis infections. Studies of cauda equina syndrome in well-controlled HIV infection are lacking. We describe such a case of cauda equina syndrome in a well-controlled HIV-infected patient, along with a brief review of the literature regarding the syndrome's diagnosis and treatment in individuals with HIV infection. CASE PRESENTATION: A 36-year-old Greek male, HIV-positive patient presented with perineal and left hemiscrotal numbness, lumbar pain, left-sided sciatica, and urinary incontinence. Magnetic resonance imaging of the patient's lumbar spine revealed intrathecal migration of a fragment from an intervertebral lumbar disk exerting pressure on the cauda equina. A cerebrospinal fluid examination, brain computed tomography scan, spine magnetic resonance imaging, and serological test results were negative for central nervous system infections. Our patient underwent emergency neurosurgical spinal decompression, which resolved most symptoms, except for mild urinary incontinence.

conclusionsNoninfectious etiologies may also cause cauda equina syndrome in HIV-infected individuals, especially in well-controlled disease under antiretroviral therapy. Prompt recognition and treatment of the underlying cause is important to minimize residual symptoms. Targeted antimicrobial chemotherapy is used to treat infectious causes, while prompt surgical decompression is favored for anatomical causes of cauda equina syndrome in the HIV-infected patient.

Indexed as

Acute DiseaseAdultDecompression, SurgicalDiagnosis, DifferentialGreeceHIV InfectionsHumansIntervertebral Disc DisplacementLumbar VertebraeMagnetic Resonance ImagingMalePolyradiculopathyCauda equina syndromeCMVHIVLumbar disk fragmentMycobacterium tuberculosisMyeloradiculopathy

Identifiers

PMID27268102
PMCPMC4895963
OpenAlexW2411623600

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.