title: Varicella zoster virus meningo-encephalo-myelitis in an immunocompetent patient.
abstract: OBJECTIVE
  To describe clinical, MRI and cerebrospinal fluid (CSF) features of a varicella zoster virus (VZV) related meningo-encephalo-myelitis (MEM) without rash in an immunocompetent female.
  
  
  METHODS
  An 85 year old immunocompetent woman with mild hyperthermia and acute, severe MEM.
  
  
  METHODS
  Serum antibodies and CSF PCR were searched for several viruses. Brain and spinal cord MRI were performed. Immunological profile.
  
  
  METHODS
  i.v. acyclovir 30 mg/kg/day; i.v. 6-MP 125 mg/day.
  
  
  RESULTS
  Marked CSF lymphomonocytic pleocytosis, blood-brainbarrier damage, and PCR detection of 3.05 X 10 6 copies of VZV DNA. MRI revealed lesions of the meninges, brain and spinal cord. No evidence of immunosuppression.
  
  
  CONCLUSIONS
  We highlight the importance of considering the possibility of VZV related MEM, even in immunocompetent patients. We also provide a MRI description of VZV related multifocal myelitis, not previously available. As supported by other reports, we underline the necessity of a prompt therapeutic intervention in this life-threatening condition.
authors.affiliation: Department of Clinical Neurology, C. Mondino IRCCS Foundation, Pavia, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Tavazzi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Minoli
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ferrante
authors.forename: Paola
authors.initials: P
authors.lastname: Scagnelli
authors.forename: Serena
authors.initials: S
authors.lastname: Del Bue
authors.forename: Alfredo
authors.initials: A
authors.lastname: Romani
authors.forename: Sabrina
authors.initials: S
authors.lastname: Ravaglia
authors.forename: Enrico
authors.initials: E
authors.lastname: Marchioni
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D001812:Blood-Brain Barrier / Q000276:immunology / Q000473:pathology / Q000821:virology; D001921:Brain / Q000276:immunology / Q000473:pathology / Q000821:virology; D002555:Cerebrospinal Fluid / Q000166:cytology; D042241:Early Diagnosis; D020804:Encephalitis, Varicella Zoster / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008587:Meningitis, Viral / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D013116:Spinal Cord / Q000276:immunology / Q000473:pathology / Q000821:virology; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir