Successful treatment of varicella zoster virus meningoencephalitis in patients with AIDS: report of four cases and review.

OBJECTIVE

Neurologic complications are common in patients with AIDS. Herpes zoster is a common early manifestation of HIV infection, but there have been few reports of encephalitic complications and nearly all have been postmortem. We report four cases of varicella zoster virus (VZV) meningoencephalitis diagnosed and treated antemortem, and briefly review the relevant literature.

SETTING

Mount Zion Medical Center, San Francisco, California, USA.

PATIENTS

Four HIV-positive male patients with antibodies to VZV in their cerebrospinal fluid.

INTERVENTION

Treatment with intravenous acyclovir (three cases) and intravenous ganciclovir (one case), which resulted in resolution of all symptoms except blindness in one patient.

CONCLUSION

Antibodies to VZV in the cerebrospinal fluid of HIV-positive individuals may allow early diagnosis and lifesaving treatment of VZV meningoencephalitis.