title: [Case of varicella myelitis in nursing care worker].
abstract: Varicella myelitis is very rarely observed in healthy adult. We report the case of 25-year-old nursing care worker who suffered from chickenpox for the first time. Approximately 2 weeks prior to the development of the symptoms, she cared for an old man who suffered from herpes zoster. She was admitted to our hospital, and she complained of weakness and paresthesia in the lower limbs. Subsequently, she experienced vesicorectal disorders: this was followed 5 days later by the appearance of a rash. Spinal T2-weighted MR images showed a high-intensity lesion in the spinal cord at the level of Th9/10, and both IgM-type anti-VZV antibodies and VZV-DNA were present in her cerebrospinal fluid. Treatment comprising a combination of acyclovir at 1,500 mg/day for 14 days and gamma-globulin with high titer of IgG-type anti-VZV antibodies at 5 g/day for 5 days result in remarkable improvement. She was able to walk again. The high-intensity lesion in the spinal T2-weighted MR images disappeared. Urinary dysfunction disappeared completely after 5 months. Care persons without anti-IgG antibodies against VZV are at a high risk of contracting varicella infection. Guidelines for infection control in home care, as well as hospitals, are necessary for caregivers.
authors.affiliation: Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Yanagido, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Takei-Suzuki
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Akio
authors.initials: A
authors.lastname: Kimura
authors.forename: Mamoru
authors.initials: M
authors.lastname: Nagasawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Koumura
authors.forename: Takeo
authors.initials: T
authors.lastname: Sakurai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Isao
authors.initials: I
authors.lastname: Hozumi
authors.forename: Takashi
authors.initials: T
authors.lastname: Inuzuka
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage; D000328:Adult; D017028:Caregivers; D005260:Female; D006282:Health Personnel; D006562:Herpes Zoster / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D017053:Infection Control; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D009187:Myelitis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D009732:Nursing Care; D009784:Occupational Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D016273:Occupational Exposure; D012306:Risk; D005719:gamma-Globulins / Q000008:administration & dosage
chemical_list: D005719:gamma-Globulins; D000212:Acyclovir