PMID: 11902456Mar 21, 2002Paper

Meningoencephalomyelitis with vasculitis due to varicella zoster virus: a case report and review of the literature

Pathology
Penelope A McKelvieEdward Byrne

Abstract

Varicella zoster virus (VZV) encephalitis is associated with large or small vessel vasculopathy. We report the case of a 67-year-old woman with a history of non-Hodgkin's lymphoma and cancers of the breast and colon, who presented with a zosteriform rash and Brown-Sequard syndrome. Despite 10 days therapy with intravenous acyclovir, meningoencephalitis developed and the patient died 15 days after onset of neurological symptoms. Autopsy showed meningoencephalomyelitis with necrotising vasculitis of leptomeningeal vessels, which is a rare complication of VZV, and we review the literature of the nine similar published cases. Polymerase chain reaction of cerebrospinal fluid for VZV was negative 6 days after onset of neurological symptoms, but became positive by day 10. Only one multinucleated giant cell with intranuclear Cowdry type A inclusions was seen within an endothelial cell in a leptomeningeal vessel involved by vasculitis.

References

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Citations

Jul 25, 2008·Rheumatology International·Simone AppenzellerFernando Cendes
Mar 5, 2004·Medical Microbiology and Immunology·Stephan W AberleElisabeth Puchhammer-Stöckl
Jan 9, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Christina C ChangSharon R Lewin
Dec 16, 2003·Current Opinion in Rheumatology·Susanne Benseler, Rayfel Schneider
Mar 20, 2010·Rinshō shinkeigaku = Clinical neurology·Megumi BesshoHaruko Kitaoka
Jan 22, 2008·Heart & Lung : the Journal of Critical Care·Maria MpakaEpaminondas Zakynthinos
Apr 9, 2009·Pediatric Blood & Cancer·Jutte E van der Werff ten BoschRobbert G M Bredius
Jan 1, 2015·Nature Reviews. Disease Primers·Anne A GershonKoichi Yamanishi
Sep 11, 2014·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Xun ShenHuaihai Qin
Jan 28, 2014·Journal of the Neurological Sciences·Inés González-SuárezExuperio Diez-Tejedor
May 9, 2012·Journal of the Neurological Sciences·Chih-Hsien HungLong-Sun Ro
Mar 17, 2017·BMC Infectious Diseases·Liang-Kung ChenChang Won Won
Jul 1, 2014·The Neuroradiology Journal·Francisco ChiangMauricio Castillo
Jun 27, 2020·BMJ Case Reports·Jessica Hyejin OhMuhammad Ghazanfar Husnain
Sep 1, 2021·BMJ Case Reports·Anjely Pulparampil SebastianDominic Benjamin
Dec 24, 2004·La Presse médicale·Pascal Cohen, Loïc Guillevin

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