Rodrigues Filipa, Santos Mariana, Macedo Eduardo, Rocha José Miguel, Silva Luís, Oliveira Ana S, Alves Joana, Apolinário Isabel
Internal Medicine, Hospital de Braga, Braga, PRT.
Neuroradiology, Hospital de Braga, Braga, PRT.
Cureus. 2023 Sep 16;15(9):e45378. doi: 10.7759/cureus.45378. eCollection 2023 Sep.
Infection with the varicella-zoster virus (VZV) is very common worldwide and is one of the main causes of infectious encephalitis. Immunosuppressed patients are at increased risk of severe disease and central nervous system (CNS) involvement. We report the case of a 43-year-old man with HIV infection and poor adherence to antiretroviral therapy who presented to the emergency department (ER) with complaints of diplopia and a frontal headache, referring to having a child with chickenpox. Brain magnetic resonance imaging revealed three hyperintense T2-weighted lesions surrounded by edema in the right sublenticular, left occipital and left parietal regions, and VZV DNA was detected in the cerebrospinal fluid (CSF). After admitting the diagnosis of VZV encephalitis, the patient was treated with intravenous acyclovir, with clinical improvement and a favorable outcome.
水痘带状疱疹病毒(VZV)感染在全球非常普遍,是传染性脑炎的主要病因之一。免疫抑制患者患重症疾病和中枢神经系统(CNS)受累的风险增加。我们报告一例43岁男性,感染HIV且对抗逆转录病毒治疗依从性差,因双眼复视和前额头痛就诊于急诊科(ER),称其孩子患了水痘。脑磁共振成像显示在右侧豆状核下、左侧枕叶和左侧顶叶区域有三个T2加权高信号病变,周围有水肿,脑脊液(CSF)中检测到VZV DNA。确诊为VZV脑炎后,该患者接受了静脉注射阿昔洛韦治疗,临床症状改善,预后良好。