Abstract
Objective
To describe clinical, MRI and cerebrospinal fluid (CSF) features of a varicella zoster virus (VZV) related meningo-encephalo-myelitis (MEM) without rash in an immunocompetent female.
Patient
An 85 year old immunocompetent woman with mild hyperthermia and acute, severe MEM.
Intervention
Serum antibodies and CSF PCR were searched for several viruses. Brain and spinal cord MRI were performed. Immunological profile.
Treatments
i.v. acyclovir 30 mg/kg/day; i.v. 6-MP 125 mg/day.
Results
Marked CSF lymphomonocytic pleocytosis, blood-brainbarrier damage, and PCR detection of 3.05 X 10 6 copies of VZV DNA. MRI revealed lesions of the meninges, brain and spinal cord. No evidence of immunosuppression.
Conclusion
We highlight the importance of considering the possibility of VZV related MEM, even in immunocompetent patients. We also provide a MRI description of VZV related multifocal myelitis, not previously available. As supported by other reports, we underline the necessity of a prompt therapeutic intervention in this life-threatening condition.
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Tavazzi, E., Minoli, L., Ferrante, P. et al. Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient. Neurol Sci 29, 279–283 (2008). https://doi.org/10.1007/s10072-008-0982-6
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DOI: https://doi.org/10.1007/s10072-008-0982-6