[Transverse myelitis and cauda equina syndrome followed by varicella in a patient with varicella-zoster virus infection].

Abstract

A 74-year-old man was admitted to our hospital with complaints of weakness in the lower extremities, urinary retention for 10 days, and generalized vesicular rash for 7 days. Spinal magnetic resonance imaging showed contrast enhancement at the Th12-L1 level of the spinal cord and cauda equina. Serum and cerebrospinal fluid varicella-zoster virus (VZV)-immunoglobulin (Ig) G antibody titers were markedly elevated, and VZV-IgM was detected in cerebrospinal fluid. The patient was diagnosed with VZV transverse myelitis and cauda equina syndrome with subsequent varicella and was treated with acyclovir and prednisolone. Two months later, muscle weakness, and dysuria had almost completely resolved. We hypothesize that latent VZV in the ganglia reactivated and caused transverse myelitis, which subsequently spread to the body via the bloodstream, resulting in the development of varicella.

• Authors: Takumi Shimazu, Daigo Yasutomi, Norie Ito, Susumu Chiba, Akihito Nambu
• Journal: Rinsho shinkeigaku = Clinical neurology (Rinsho Shinkeigaku) Vol. 63 Issue 10 Pg. 637-642 (Oct 25 2023) ISSN: 1882-0654 [Electronic] Japan
• PMID: 37779026 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Immunoglobulin G

Topics

• Male
• Humans
• Aged
• Herpesvirus 3, Human
• Myelitis, Transverse
• Chickenpox (complications)
• Cauda Equina Syndrome (complications)
• Myelitis (diagnosis, drug therapy, etiology)
• Herpes Zoster (complications)
• Immunoglobulin G