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Varicella-zoster virus limbic encephalitis in an immunocompromised patient
P Tattevin1, F Schortgen, T de Broucker
1Clinique des Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Rennes, France.
Scandinavian Journal of Infectious Diseases
|December 1, 2001
Summary
A case of limbic encephalitis caused by varicella-zoster virus (VZV) in an immunosuppressed patient is presented. Early diagnosis and antiviral treatment are crucial for recovery, highlighting VZV as a cause of limbic encephalitis.
Area of Science:
- Neurology
- Infectious Diseases
- Neuroimmunology
Background:
- Limbic encephalitis is a rare neurological disorder.
- Immunosuppressive therapy for conditions like microscopic polyangiitis can increase infection risk.
- Varicella-zoster virus (VZV) can cause central nervous system infections.
Observation:
- A patient on immunosuppressants developed limbic encephalitis with characteristic MRI findings.
- Cerebrospinal fluid analysis confirmed VZV DNA via PCR.
- Delayed antiviral treatment was initiated 11 days after symptom onset.
Findings:
- Intravenous acyclovir treatment led to VZV DNA clearance in CSF.
- Brain lesions resolved on follow-up MRI scans.
- This case suggests limbic encephalitis can be a manifestation of VZV infection.
Implications:
- Varicella-zoster virus should be considered in immunocompromised patients with limbic encephalitis.
- Early PCR testing of CSF for VZV DNA is recommended for prompt diagnosis.
- Timely antiviral therapy may improve outcomes in VZV-induced limbic encephalitis.