Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient.

Neurol Sci 2008 Sep 20;29(4):279-83. Epub 2008 Sep 20.

Department of Clinical Neurology, C. Mondino IRCCS Foundation, Pavia, Italy.

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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http://dx.doi.org/10.1007/s10072-008-0982-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570049PMC
September 2008
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