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Neurological Sciences

, Volume 29, Issue 4, pp 279–283 | Cite as

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

  • Eleonora Tavazzi
  • Lorenzo Minoli
  • Pasquale Ferrante
  • Paola Scagnelli
  • Serena Del Bue
  • Alfredo Romani
  • Sabrina Ravaglia
  • Enrico MarchioniEmail author
Brief Communication

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.

Keywords

Varicella-zoster Meningitis Encephalomyelitis Immunocompetence Vasculitis 

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Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Eleonora Tavazzi
    • 1
  • Lorenzo Minoli
    • 2
  • Pasquale Ferrante
    • 3
    • 4
  • Paola Scagnelli
    • 5
  • Serena Del Bue
    • 3
  • Alfredo Romani
    • 1
  • Sabrina Ravaglia
    • 1
  • Enrico Marchioni
    • 1
    Email author
  1. 1.Department of Clinical Neurology“C. Mondino” IRCCS FoundationPaviaItaly
  2. 2.Department of Infectious Diseases“Policlinico San Matteo” IRCCS FoundationPaviaItaly
  3. 3.Laboratory of Virology Department of Biomolecular Science and TechnologyUniversity of MilanMilanItaly
  4. 4.San Giuseppe HospitalMilanItaly
  5. 5.Department of Neuroradiology“Policlinico San Matteo” IRCCS FoundationPaviaItaly

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