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Article 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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2570049 | PMC |
| http://dx.doi.org/10.1007/s10072-008-0982-6 | DOI Listing |
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