Varicella zoster virus infectious vasculopathy: Case report

A very particular case is described, due to its low frequency and potential effect on morbidity and mortality, of a 20-year-old male with human immunodeficiency virus (HIV) infection with neurological manifestations including first focal epileptic seizure, right amaurosis, left hemiparesis and ipsilateral hyperreflexia. Magnetic resonance imaging revealed absence of contrast filling in the right internal carotid artery, old infarction in the territory of the right middle cerebral artery and laminar necrosis of the left caudate nucleus. The cytochemical analysis of the cerebrospinal fluid was normal, however, the polymerase chain reaction (PCR) was positive for the Varicella Zoster Virus (VZV). The patient was receiving acyclovir and corticosteroid with adequate response to treatment. It is understood then that VZV vasculopathy is part of a broad group of differential diagnoses and that molecular tests in cerebrospinal fluid (CSF) should be included as a sensitive and specific tool.