A Case of Transverse Myelitis Caused by Varicella Zoster Virus in an Immunocompetent Older Patient

• Published in: Infection & chemotherapy Vol. 48; no. 4; pp. 334 - 337
• Main Authors: Lee, Jeong Eun, Lee, Shinwon, Kim, Kye-Hyung, Jang, Hee Ryeong, Park, Young Joo, Kang, Jin Suk, Han, Sung Yong, Lee, Sun Hee
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 01.12.2016; 대한감염학회
• Subjects: Case Report; 내과학; Varicella zoster virus; Older patients; Antiviral treatment; Immunocompetent; Transverse myelitis
• ISSN: 2093-2340; 2092-6448
• DOI: 10.3947/ic.2016.48.4.334

Varicella zoster virus (VZV) is a human neurotropic alphaherpesvirus that causes chickenpox (varicella) in children. VZV reactivation may lead to neurological complications, including transverse myelitis. However, transverse myelitis caused by VZV reactivation is rare in immunocompetent patients. Herein, we report a case of transverse myelitis caused by VZV in an immunocompetent older patient, and confirmed this case by polymerase chain reaction. A 79-year-old woman visited our service with complaints of weakness in the right lower leg, generalized vesicular eruptions, and throbbing pain in the right flank for ten days. Spine MRI showed transverse myelitis in the thoracic spine at level T4-T11. The patient was treated with acyclovir and her neurological functions improved, except for sensory impairment below level T10. For older patients, early and aggressive antiviral treatment against VZV may be necessary even though these patients are immunocompetent.