Hemorrhagic Stroke Due to Varicella Zoster Virus Vasculopathy

被引：1

作者：

Hofstrand, Reese ^{[1
]}

Portela, Rafael ^{[1
]}

Juneau, Ryan ^{[1
]}

Okafor, Chika ^{[1
]}

Watts, Ryan ^{[2
]}

机构：

[1] Cape Fear Valley Med Ctr, Internal Med, Fayetteville, NC 28304 USA

[2] Campbell Univ, Sch Osteopath Med, Cardiothorac Surg, Lillington, NC USA

来源：

CUREUS JOURNAL OF MEDICAL SCIENCE | 2023年 / 15卷 / 03期

关键词：

hiv; mri brain; vasculitis; punctate hemorrhage; varicella-zoster;

D O I：

10.7759/cureus.36604

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Varicella-zoster virus (VZV) vasculopathy is a granulomatous vasculitis that has a wide variety of clinical presentations. It is most common in patients with HIV not on anti-retroviral therapy (ART) with low cluster of differentiation (CD)4 cell counts. This disease affects the central nervous system and can cause small intracranial bleeds. Our patient presented with stroke-like symptoms in the setting of recent VZV reactivation in the ophthalmic distribution with HIV on ART. Her MRI scan showed a small punctate bleed and the CSF workup was consistent with VZV vasculitis. She was treated with 14 days of acyclovir and five days of high-dose steroids with clinical improvement to baseline.

引用

页数：6

共 9 条

[1]

Flores Rosario Karen, 2020, Case Rep Transplant, V2020, P5049627, DOI 10.1155/2020/5049627

[2] Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment [J].

Gilden, Don ;

Cohrs, Randall J. ;

Mahalingam, Ravi ;

Nagel, Maria A. .

LANCET NEUROLOGY, 2009, 8 (08) :731-740

[3] HIV vasculopathy versus VZV vasculitis in an HIV patient with multiple brain ischaemic infarcts [J].

Granja, Manuel F. ;

Monteiro, Andre ;

Day, Jason ;

Hanel, Ricardo .

BMJ CASE REPORTS, 2019, 12 (07)

[4] Central nervous system varicella zoster vasculopathy in an immunocompromised patient [J].

Guedes, Mariana ;

Filipe, Rita ;

Costa, Andreia ;

Soares, Carolina ;

Sarmento, Antonio ;

Tavares, Margarida .

IDCASES, 2019, 15

[5] The varicella zoster virus vasculopathies -: Clinical, CSF, imaging, and virologic features [J].

Nagel, M. A. ;

Cohrs, R. J. ;

Mahalingam, R. ;

Wellish, M. C. ;

Forghani, B. ;

Schiller, A. ;

Safdieh, J. E. ;

Kamenkovich, E. ;

Ostrow, L. W. ;

Levy, M. ;

Greenberg, B. ;

Russman, A. N. ;

Katzan, I. ;

Gardner, C. J. ;

Haeusler, M. ;

Nau, R. ;

Saraya, T. ;

Wada, H. ;

Goto, H. ;

de Martino, M. ;

Ueno, M. ;

Brown, W. D. ;

Terborg, C. ;

Gilden, D. H. .

NEUROLOGY, 2008, 70 (11) :853-860

[6] Varicella Zoster Virus Vasculopathy [J].

Nagel, Maria A. ;

Bubak, Andrew N. .

JOURNAL OF INFECTIOUS DISEASES, 2018, 218 :S107-S112

[7] The Short- and Long-Term Risk of Stroke after Herpes Zoster - A Nationwide Population-Based Cohort Study [J].

Sreenivasan, Nandini ;

Basit, Saima ;

Wohlfahrt, Jan ;

Pasternak, Bjorn ;

Munch, Tina N. ;

Nielsen, Lars P. ;

Melbye, Mads .

PLOS ONE, 2013, 8 (07)

[8] CNS VARICELLA-ZOSTER VASCULITIS [J].

VILCHEZPADILLA, JJ ;

REDON, J ;

RUIZ, A ;

LOPEZALDEGUER, J .

ARCHIVES OF NEUROLOGY, 1982, 39 (12) :785-785

[9] Herpes zoster and postherpetic neuralgia [J].

Watson, C. Peter N. .

CANADIAN MEDICAL ASSOCIATION JOURNAL, 2010, 182 (16) :1713-1714

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