Herpes zoster myelitis occurring during treatment for systemic lupus erythematosus

A 15-year-old girl with systemic lupus erythematosus suddenly developed fever, meningismus, and herpes zoster. Within 48 hours, transverse myelitis developed at the level of the nerve root involvement of the herpes zoster. Since both systemic lupus erythematosus and varicella-zoster have been reported to cause myelitis, therapy was initiated for both. The rapid and simultaneous resolution of both the herpes zoster and the neurologic deficits strongly supports the causal association of both with varicella-zoster. This is the second reported case of herpes zoster-associated transverse myelitis in a patient with systemic lupus erythematosus.