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Acute ascending necrotizing myelopathy caused by herpes simplex virus type 2
C A Wiley1, P D VanPatten, P M Carpenter
1Department of Pathology (Neuropathology), University of California, San Diego, La Jolla 92093.
Neurology
|November 1, 1987
Summary
Herpes simplex virus type 2 (HSV2) caused a rapidly ascending necrotizing myelitis in a diabetic patient. This case highlights HSV2 as a potential, often unidentified, cause of severe spinal cord infections.
Area of Science:
- Neurology
- Virology
- Pathology
Background:
- Necrotizing myelitis is a severe spinal cord inflammation.
- Herpes simplex virus type 2 (HSV2) is a known cause of neurological disease, but rarely associated with myelitis.
Observation:
- A 57-year-old diabetic man presented with rapidly ascending necrotizing myelitis.
- Autopsy revealed herpes simplex virus type 2 (HSV2) as the etiologic agent.
Findings:
- Post-mortem analysis, including immunohistopathology and electron microscopy, confirmed HSV2 infection of the central nervous system (CNS).
- The infection likely spread from dorsal root ganglia to the spinal cord, causing direct extension and brainstem involvement, leading to death.
Implications:
- Herpes simplex virus type 2 (HSV2) may be an underrecognized cause of necrotizing myelitis.
- Diagnostic challenges include negative CSF cultures and rare visualization of viral markers, necessitating advanced diagnostic approaches for etiological identification.