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Varicella-zoster virus (VZV) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma
Cerebral vasculopathy due to varicella-zoster virus (VZV) infection is well-documented. We report a fatal case of VZV multifocal vasculopathy in a patient with systemic lupus erythematosus (SLE) who presented with subacute changes in mental status and had multiple areas of hemorrhagic infarcts on br...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423343/ https://www.ncbi.nlm.nih.gov/pubmed/28491814 http://dx.doi.org/10.1016/j.idcr.2017.04.010 |
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author | Osiro, Stephen Salomon, Nadim |
author_facet | Osiro, Stephen Salomon, Nadim |
author_sort | Osiro, Stephen |
collection | PubMed |
description | Cerebral vasculopathy due to varicella-zoster virus (VZV) infection is well-documented. We report a fatal case of VZV multifocal vasculopathy in a patient with systemic lupus erythematosus (SLE) who presented with subacute changes in mental status and had multiple areas of hemorrhagic infarcts on brain imaging. However, the correct diagnosis was delayed by several confounding factors including the absence of zoster rash, normal cerebral angiography, persistently low cerebrospinal fluid (CSF) glucose and negative initial polymerase chain reaction (PCR) for VZV DNA in the CSF. Our case and literature review suggests that the sensitivity of PCR for VZV DNA in the CSF is low in VZV vasculopathy and clinical suspicion of this disease in the setting of characteristic imaging findings could be crucial to timely diagnosis. |
format | Online Article Text |
id | pubmed-5423343 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-54233432017-05-10 Varicella-zoster virus (VZV) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma Osiro, Stephen Salomon, Nadim IDCases Case Report Cerebral vasculopathy due to varicella-zoster virus (VZV) infection is well-documented. We report a fatal case of VZV multifocal vasculopathy in a patient with systemic lupus erythematosus (SLE) who presented with subacute changes in mental status and had multiple areas of hemorrhagic infarcts on brain imaging. However, the correct diagnosis was delayed by several confounding factors including the absence of zoster rash, normal cerebral angiography, persistently low cerebrospinal fluid (CSF) glucose and negative initial polymerase chain reaction (PCR) for VZV DNA in the CSF. Our case and literature review suggests that the sensitivity of PCR for VZV DNA in the CSF is low in VZV vasculopathy and clinical suspicion of this disease in the setting of characteristic imaging findings could be crucial to timely diagnosis. Elsevier 2017-04-25 /pmc/articles/PMC5423343/ /pubmed/28491814 http://dx.doi.org/10.1016/j.idcr.2017.04.010 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Osiro, Stephen Salomon, Nadim Varicella-zoster virus (VZV) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma |
title | Varicella-zoster virus (VZV) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma |
title_full | Varicella-zoster virus (VZV) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma |
title_fullStr | Varicella-zoster virus (VZV) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma |
title_full_unstemmed | Varicella-zoster virus (VZV) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma |
title_short | Varicella-zoster virus (VZV) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma |
title_sort | varicella-zoster virus (vzv) multifocal vasculopathy in a patient with systemic lupus erythematosus — a diagnostic and treatment dilemma |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423343/ https://www.ncbi.nlm.nih.gov/pubmed/28491814 http://dx.doi.org/10.1016/j.idcr.2017.04.010 |
work_keys_str_mv | AT osirostephen varicellazostervirusvzvmultifocalvasculopathyinapatientwithsystemiclupuserythematosusadiagnosticandtreatmentdilemma AT salomonnadim varicellazostervirusvzvmultifocalvasculopathyinapatientwithsystemiclupuserythematosusadiagnosticandtreatmentdilemma |