Cervical Varicella-Zoster Virus Myelitis in a Patient Receiving Weekly Low-Dose Methotrexate
Naritaka Morikawa1, Kohei Kamegai1, Misa Yamaji2
1Disease Control and Prevention Center, Japan Institute for Health Security, Japan.
Internal Medicine (Tokyo, Japan)
|April 29, 2026
Summary
Varicella-zoster virus (VZV) myelitis, a rare neurological condition, can cause lasting central nervous system damage. This case study shows successful treatment with antiviral drugs and steroids, offering hope for VZV myelitis patients.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Varicella-zoster virus (VZV) myelitis is a rare neurological infection.
- It typically affects immunocompromised individuals and has limited reported cases.
- No established treatment protocols currently exist for VZV myelitis.
Purpose of the Study:
- To report a successful treatment of VZV myelitis and disseminated herpes zoster.
- To discuss the etiology of VZV myelitis, even in mild immunosuppression.
- To explore preventive measures against VZV reinfection and relapse.
Main Methods:
- A case report of a 46-year-old female patient with VZV myelitis and disseminated herpes zoster.
- Treatment involved antiviral drug administration.
- Treatment included high-dose steroid pulse therapy.
Main Results:
- Successful recovery from VZV myelitis and disseminated herpes zoster.
- Demonstrated efficacy of combined antiviral and steroid pulse therapy.
- Highlighted the occurrence of myelitis despite only mild cellular immunosuppression.
Conclusions:
- Antiviral drug administration combined with steroid pulse therapy can be an effective treatment for VZV myelitis.
- Further research is needed to understand the etiology and prevention strategies for VZV myelitis, particularly in non-severely immunocompromised individuals.
- This case contributes valuable clinical experience for managing this rare neurological complication.
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