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Evidence for Vascular Spread of Varicella Zoster–Associated Vasculopathy
- Takeshi Saraya, MD;
- Chie Shimura, MD;
- Hiroo Wada, MD, PhD;
- Masahiro Aoshima, MD, PhD; and
- Hajime Goto, MD, PhD
- From Kyorin University School of Medicine, Mitaka City, Tokyo 181-8611, Japan.
TO THE EDITOR:
Background: Varicella zoster virus (VZV) infection may provoke life-threatening cerebrovasculopathy. Diagnosis in immunocompromised patients is often complicated because of the possibility of multiple infections (1, 2). We present unique magnetic resonance angiographic images of VZV-associated cerebrovasculopathy in an immunocompromised patient.
Case Report: A 36-year-old homosexual man with HIV infection was hospitalized for evaluation of convulsions. He had a vesicular rash on the right knee, redness and itching sensations in the right eye (herpes zoster ophthalmicus), neck stiffness, and a temperature as high as 38 °C. Neurologic examination revealed memory loss and inability to perform simple arithmetic. The patient did not have ptosis, significant vision loss, or ocular cranial nerve palsies. Results of laboratory studies revealed a CD4 cell count of 0.036 × …
