Internal Medicine, Bangalore Baptist Hospital, Bangalore, Karnataka, India
Internal Medicine, Bangalore Baptist Hospital, Bangalore, Karnataka, India.
BMJ Case Rep. 2021 Aug 30;14(8):e238078. doi: 10.1136/bcr-2020-238078.
Transverse myelitis is a rare neurological complication seen with varicella-zoster virus (VZV) infection, which is common among immunocompromised hosts. It can occur during the primary VZV infection or reactivation of latent infection. It is a complication that requires prompt diagnosis and treatment. The present case is that of a 28-year-old immunocompetent man, who presented with fever, rash and acute-onset spastic paraparesis with bladder involvement. Causes such as herpes simplex 1 and 2, cytomegalovirus, enterovirus and Epstein-Barr virus infection were ruled out. On evaluation, he was diagnosed with acute primary disseminated VZV infection with parainfectious transverse myelitis, based on positive cerebrospinal fluid multiplex PCR (PCR) and serum VZV IgM antibodies. He was treated with intravenous acyclovir and steroids, with which he improved significantly.
横断性脊髓炎是一种罕见的与水痘带状疱疹病毒（VZV）感染相关的神经系统并发症，常见于免疫功能低下者。它可发生在原发性 VZV 感染或潜伏感染再激活期间。这是一种需要及时诊断和治疗的并发症。本病例为一例 28 岁免疫功能正常的男性，以发热、皮疹和急性痉挛性截瘫伴膀胱功能障碍起病。排除了单纯疱疹病毒 1 型和 2 型、巨细胞病毒、肠道病毒和 EBV 感染等病因。评估后，根据脑脊液多重 PCR（PCR）和血清 VZV IgM 抗体阳性，诊断为急性原发性播散性 VZV 感染伴副感染性横断性脊髓炎。他接受了阿昔洛韦静脉注射和类固醇治疗，症状显著改善。
