Neurological complications of reactivated Varicella Zoster virus infection

Abstract number: s43

Bergström  T.

Varicella Zoster virus (VZV) infections of the central nervous system (CNS) constitute a major part of the burden of disease of this virus. The clinical scope includes encephalitis, brain stem encephalitis, myelitis, cerebellitis, cerebral vasculitis, ventriculitis, facial palsy, radiculitis and meningitis. Recently, improved diagnostics has revealed that VZV is a major CNS virus in several European countries. We here present clinical and laboratory data on 76 cases, collected during 1992–2005 in the Göteborg area, in whom VZV DNA was detected by PCR in the cerebrospinal fluid (CSF). During the last three-year period, the yearly incidence of VZV CNS infections rose sharply to become the most frequently detected virus in CSF at our laboratory. This shift coincided with the introduction of a novel TaqMan PCR system based on the gene coding for glycoprotein B. The age-related incidence was surprisingly evenly distributed with the exception of a peak at 70–80 years. In line with studies by others, a large proportion of the cases had no skin lesions, i.e. neither shingles nor zoster. These two findings are compatible with that VZV might recur more often during life than previously thought and that manifestations in "CNS only" might be a clinically important part of the VZV disease spectrum. Viral DNA quantities in the CSF were found to be high as compared with similar data from CNS infections caused by herpes simplex virus 1 and 2. We suggest that VZV should be sought for in all cases of CNS infections of suspected viral origin that recommendations regarding doses and duration of antiviral therapy of such VZV infections should be thoroughly discussed, and that long-term follow-up studies of neurological outcome should be performed.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Location: Oxford, UK
Presentation type:
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