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Disseminated cutaneous herpes zoster and multiple cerebral infarcts in an adult with diabetes mellitus

  • Chun-Fu Lin
  • Chien-Tai Hong
  • Wei-Hwa Lee
  • Dean Wu
  • Chaur-Jong Hu
  • Chen-Chih ChungEmail author
Case Report
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Abstract

Ischemic stroke is a rare complication of varicella-zoster virus (VZV) infection. We present the case of a patient with a medical history of type 2 diabetes mellitus (DM) who experienced disseminated cutaneous VZV infection followed by multiple cerebral infarcts associated with VZV vasculopathy. Brain magnetic resonance imaging revealed multiple hyperintense lesions over the bilateral deep white matter and basal ganglia. A skin biopsy revealed small-vessel leukocytoclastic vasculitis with neutrophilic, lymphocytic, and eosinophilic infiltration. This case report describes the rare finding of cutaneous leukocytoclastic vasculitis in VZV infection and highlights that VZV infection is an uncommon but critical etiology of cryptogenic stroke in patients with DM.

Keywords

Diabetes mellitus Varicella-zoster virus Vasculitis Vasculopathy Stroke 

Abbreviations

VZV

Varicella zoster virus

DM

Diabetes mellitus

IgM

Immunoglobulin M

MRI

Magnetic resonance imaging

FLAIR

Fluid-attenuated inversion recovery

DWI

Diffusion-weighted imaging

CSF

Cerebrospinal fluid

Notes

Acknowledgments

This manuscript was edited by Wallace Academic Editing.

Compliance with ethical standards

The study was approved by the Taipei Medical University Joint Institutional Review Board (No. N20190387).

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Journal of NeuroVirology, Inc. 2020

Authors and Affiliations

  1. 1.Department of Neurology, Shuang Ho HospitalTaipei Medical UniversityNew Taipei CityTaiwan
  2. 2.Taipei Neuroscience InstituteTaipei Medical UniversityTaipeiTaiwan
  3. 3.Department of Neurology, School of Medicine, College of MedicineTaipei Medical UniversityTaipeiTaiwan
  4. 4.Department of pathology, Shuang Ho Hospital, TaipeiMedical UniversityTaipeiTaiwan
  5. 5.Graduate Institute of Biomedical Informatics, College of Medical Science and TechnologyTaipei Medical UniversityTaipeiTaiwan

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