Normal laboratory values included serum chemistry, calcium, lactate, and liver and renal function tests; copper and ceruloplasmin levels; antinuclear and anti-DNA antibody tests; rheumatoid factor and complement factor C3 and C4 levels; anticardiolipin antibody tests; anti–double-stranded DNA, antineutrophil cytoplasmic, anti–smooth muscle, anti–ribonucleoprotein, anti-Ro, anti-La, anti-Jo-1, anti-Scl-70, and antithyroid peroxidase antibody tests; and thyroid function tests. Blood leukocyte counts were 4000/μL (60% polymorphonuclear leukocytes and 10% lymphocytes). Serum immunoglobulin levels were decreased: IgG, 100 mg/dL (reference range, 0-700 mg/dL), IgA, 40 mg/dL (reference range, 0-60 mg/dL), and IgM, 5 mg/dL (reference range, 0-38 mg/dL). Peripheral blood B cells were low (<1% of lymphocytes). The CD4/CD8+ T-cell ratio was inverted (0.7). Results of serologic testing for human immunodeficiency virus were negative. Cerebrospinal fluid (CSF) examination revealed a normal blood cell count and glucose and protein content, with 4 IgG bands (absent in the serum). The Link index was 0.9 (normal, <0.75), and the Tourtellotte index was 3.9 (normal, <3.3 mg/24 h); the 14-3-3 protein was not detected. Results of investigations for the influenza, parainfluenza, Epstein-Barr, enterovirus, and herpes simplex viruses were negative in the serum and CSF. Cytomegalovirus retinitis was detected on ophthalmoscopic examination. Results of quantitative CMV polymerase chain reaction (PCR) of the serum and CSF were strongly positive (1:10 000). Good syndrome with CMV encephalitis was diagnosed, and a regimen of intravenous immunoglobulin (2 g/kg per day for 5 days) and ganciclovir (5 mg/kg every 12 hours) was started in April 2002. After diagnosis, the disease progressed quickly. The patient developed cognitive decline, diarrhea, weight loss, mucocutaneous candidiasis, fever, and systemic infections. He died in December 2002 of respiratory failure. A consent for autopsy was not granted.