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Multiple ischemic infarcts in a child with AIDS, varicella zoster infection, and cerebral vasculitis
1Department of Neurology, North Shore University Hospital, Manhasset, NY 11030.
Insights
A child with acquired immunodeficiency syndrome (AIDS) and a persistent varicella zoster virus infection developed central nervous system vasculitis and strokes. This rare complication of AIDS is typically seen in adults.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Acquired immunodeficiency syndrome (AIDS) can lead to various opportunistic infections and neurological complications.
- Varicella zoster virus (VZV) infections can be severe and prolonged in immunocompromised individuals.
Observation:
- A pediatric patient with AIDS presented with a prolonged VZV skin infection.
- The patient developed multiple ischemic strokes and evidence of central nervous system (CNS) vasculitis.
Findings:
- Radiologic and histopathologic findings confirmed CNS vasculitis.
- No typical AIDS encephalitis features or extra-nervous system vasculitis were observed.
- The CNS vasculitis was likely a consequence of persistent VZV infection due to immunodeficiency.
Implications:
- This case highlights a rare neurological complication of VZV infection in pediatric AIDS.
- It suggests that CNS vasculitis should be considered in immunocompromised children with neurological symptoms and VZV infection.
- Further research is needed to understand the pathogenesis and management of this rare condition in children.
Abstract:
A 4 1/2-year-old girl with acquired immunodeficiency syndrome and prolonged varicella zoster virus skin infection developed multiple ischemic strokes and radiologic and histopathologic evidence of central nervous system vasculitis. Typical features of acquired immunodeficiency syndrome encephalitis were not present and there was no evidence of vasculitis outside the nervous system. Central nervous system vasculitis probably resulted from varicella zoster virus infection that persisted because of immunodeficiency. This acquired immunodeficiency syndrome complication has only rarely been described in adults and to our knowledge has not been described in children.