Peripheral facial palsy leading to the diagnosis of acute HIV infection

Acute HIV infection is a challenging diagnosis that is easily missed due to the nonspecific symptoms of the HIV seroconversion syndrome; some patients might develop neurological symptoms, usually around three weeks after the onset of illness. A high HIV viral load in CSF (cerebrospinal fluid) has been associated with the presence of neurological symptoms, and a correlation between the CSF HIV RNA level and the severity of neurological symptoms has been described. We present the case of a patient who developed a peripheral facial palsy and a trigeminal neuralgia during an acute HIV infection, and the laboratory and microbiological findings, including the HIV viral load in CSF, which strongly suggest an HIV primary infection as the etiology of these neuropathies.



Abbreviations



HIV, human immunodeficiency virus; PCR, polymerase chain; MRI, magnetic resonance imaging; CSF, cerebrospinal fluid; HSV, herpes simplex virus; VZV, varicella zoster virus VZV; CNS, CNS central nervous system; ART, antiretroviral therapy