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08:04
Development of an IFN-γ ELISpot Assay to Assess Varicella-Zoster Virus-specific Cell-mediated Immunity Following Umbilical Cord Blood Transplantation
Published on: July 9, 2014
Recurrent varicella zoster virus myelopathy
Don Gilden1, Maria A Nagel, Richard M Ransohoff
1Department of Neurology, University of Colorado Denver, School of Medicine, Denver, CO, USA. don.gilden@uchsc.edu
Journal of the Neurological Sciences
|October 24, 2008
Summary
Varicella zoster virus (VZV) infection can cause myelopathy, a rare spinal cord complication. This case details the first reported recurrence of VZV myelopathy years later in an immunocompetent adult, successfully treated with antivirals.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Myelopathy, a rare complication of Varicella Zoster Virus (VZV) infection, can occur without a rash.
- Recurrent VZV myelopathy is uncommon, particularly in immunocompetent individuals.
Observation:
- A case of recurrent myelopathy caused by VZV is reported in an immunocompetent adult.
- The initial episode followed ophthalmic-distribution zoster.
- Recurrence occurred two years after the initial event, presenting with new neurological symptoms and spinal cord lesions on MRI.
Findings:
- Intrathecal synthesis of anti-VZV IgG antibodies in cerebrospinal fluid (CSF) confirmed VZV as the cause of recurrent myelopathy.
- Virological verification and prompt antiviral therapy led to the resolution of myelopathy and undetectable anti-VZV IgG antibodies in CSF.
- This represents the first documented instance of VZV myelopathy recurrence years after the initial episode in an immunocompetent adult.
Implications:
- Highlights the potential for late recurrence of VZV myelopathy even in immunocompetent patients.
- Emphasizes the importance of considering VZV in recurrent myelopathy cases, regardless of rash presence or time since initial infection.
- Demonstrates the efficacy of antiviral treatment in managing recurrent VZV-related neurological complications.
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