Faculty mentor/PI email address
Brandon.Velazquez@hudsonregionalhealth.com
Keywords
AIDS-related cauda equina syndrome unusual etiology, HIV patient cauda equina rare cause, immunocompromised cauda equina syndrome atypical etiology, AIDS-associated spinal pathology causing cauda equina, rare infectious cause cauda equina AIDS, cauda equina syndrome in advanced HIV/AIDS
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Patients with advanced HIV/AIDS are at high risk for primary central nervous system (CNS) lymphoma due to impaired immune surveillance and HIV-driven B-cell proliferation. While intracranial lesions are well recognized, spinal involvement remains underrecognized due to the scarcity of well documented report cases in current literature. In this patient,we describe the case of a 35-year-old male with a new HIV diagnosis who experienced acute bilateral lower extremity weakness and urinary retention during hospitalization for fever, perianal abscess, and urinary tract infection. Initial CD4 count revealed profound immunosuppression with a CD4 count less than 20 cells/μL and a viral load of 178,000 copies/mL. Spinal MRI demonstrated an enhancing mass at T2-T3 with surrounding edema extending to C5-C6 and multiple vertebral lesions, while brain MRI was unremarkable. The diagnosis of spinal CNS lymphoma causing cauda equina syndrome was made-a neurosurgical emergency with potential for irreversible paralysis. This case underscores the importance of early, comprehensive spinal imaging in HIV-positive patients with new-onset myelopathy or cauda equina symptoms.
Disciplines
Medicine and Health Sciences | Nervous System Diseases | Virus Diseases
Included in
Unusual Etiology of Cauda Equina Syndrome in an AIDS Patient: A Case Report
Patients with advanced HIV/AIDS are at high risk for primary central nervous system (CNS) lymphoma due to impaired immune surveillance and HIV-driven B-cell proliferation. While intracranial lesions are well recognized, spinal involvement remains underrecognized due to the scarcity of well documented report cases in current literature. In this patient,we describe the case of a 35-year-old male with a new HIV diagnosis who experienced acute bilateral lower extremity weakness and urinary retention during hospitalization for fever, perianal abscess, and urinary tract infection. Initial CD4 count revealed profound immunosuppression with a CD4 count less than 20 cells/μL and a viral load of 178,000 copies/mL. Spinal MRI demonstrated an enhancing mass at T2-T3 with surrounding edema extending to C5-C6 and multiple vertebral lesions, while brain MRI was unremarkable. The diagnosis of spinal CNS lymphoma causing cauda equina syndrome was made-a neurosurgical emergency with potential for irreversible paralysis. This case underscores the importance of early, comprehensive spinal imaging in HIV-positive patients with new-onset myelopathy or cauda equina symptoms.