Archer Timothy Michael
General Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
BMJ Case Rep. 2018 Jun 17;2018:bcr-2017-223947. doi: 10.1136/bcr-2017-223947.
This is a rare case of Varicella zoster virus (VZV) lumbosacral plexopathy in an 84-year-old women presenting with lower limb weakness and rash. Contrast-enhanced MRI showed enhancement of the left L3-L5 descending nerves and left lumbosacral plexus consistent with inflammatory/infectious aetiology. Cerebrospinal fluid PCR confirmed VZV DNA and cerebrospinal fluid serological testing was positive for VZV immunoglobulin (Ig)M and IgG antibodies. The patient was treated with intravenous acyclovir but this was complicated by the development of acute renal failure attributed to acyclovir-induced nephropathy, requiring dose adjustment. After a prolonged course of oral acyclovir and inpatient rehabilitation, the patient made a partial neurological and functional recovery.
这是一例罕见的84岁女性水痘带状疱疹病毒（VZV）腰骶丛神经病病例，患者表现为下肢无力和皮疹。增强磁共振成像（MRI）显示左侧L3 - L5下行神经及左侧腰骶丛强化，符合炎症/感染性病因。脑脊液聚合酶链反应（PCR）证实存在VZV DNA，脑脊液血清学检测显示VZV免疫球蛋白（Ig）M和IgG抗体呈阳性。患者接受了静脉注射阿昔洛韦治疗，但因阿昔洛韦诱发的肾病导致急性肾衰竭，治疗变得复杂，需要调整剂量。经过长时间口服阿昔洛韦及住院康复治疗后，患者神经功能和功能部分恢复。
