Varicella-zoster virus leukoencephalitis and cerebral vasculopathy.
Two patients with varicella-zoster virus leukoencephalitis and acquired immunodeficiency syndrome are described. Neither patient had cutaneous or disseminated varicella-zoster virus infection within the last six months of life. Demyelinated lesions resembling those of progressive multifocal leukoencephalopathy were seen in their brains at autopsy. Numerous cells with Cowdry type A intranuclear inclusions surrounded the lesions; these cells stained positively for varicella-zoster virus with immunohistochemistry and contained herpesvirus nucleocapsids by electron microscopy. Leptomeningeal vessels accompanying the lesions displayed a zoster-induced vasculopathy in one of the two patients. Vascular and parenchymal central nervous system infections with varicella-zoster virus are rare in the absence of cutaneous lesions, and to our knowledge, the presence of both in one patient has not yet been described.
Morgello
S
S
Department of Pathology (Neuropathology), New York Hospital, NY 10021.
Block
G A
GA
Price
R W
RW
Petito
C K
CK
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001921:Brain / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000473:pathology*; D004660:Encephalitis / Q000209:etiology / Q000473:pathology*; D006562:Herpes Zoster / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged