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.
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.
Authors: E Marchioni; S Ravaglia; G Piccolo; M Furione; E Zardini; D Franciotta; E Alfonsi; L Minoli; A Romani; A Todeschini; C Uggetti; E Tavazzi; M Ceroni Journal: Neurology Date: 2005-10-11 Impact factor: 9.910
Authors: F Gray; L Bélec; M C Lescs; F Chrétien; A Ciardi; D Hassine; M Flament-Saillour; P de Truchis; B Clair; F Scaravilli Journal: Brain Date: 1994-10 Impact factor: 13.501
Authors: Stephan W Aberle; Judith H Aberle; Christoph Steininger; Elisabeth Puchhammer-Stöckl Journal: Med Microbiol Immunol Date: 2004-03-02 Impact factor: 4.148
Authors: Aaron Haug; Ravi Mahalingam; Randall J Cohrs; D Scott Schmid; John R Corboy; Don Gilden Journal: J Neurol Sci Date: 2010-02-19 Impact factor: 3.181
Authors: M Ludlow; D T Nguyen; D Silin; O Lyubomska; R D de Vries; V von Messling; S McQuaid; R L De Swart; W P Duprex Journal: J Virol Date: 2012-05-02 Impact factor: 5.103