Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximab
We report a case of a 54 year old Sudanese lady admitted with dizziness, visual disturbance and collapse with nystagmus, ataxia, bilateral ptosis, and 3rd cranial nerve palsy on examination. CT and MRI scan of her head showed multiple areas of infarct. A lumbar puncture showed lymphocytosis and was...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-11-01
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| Series: | Clinical Infection in Practice |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590170224000554 |
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| author | Nisha A. George Melissa Haines Vincent Lam Julian Tang |
| author_facet | Nisha A. George Melissa Haines Vincent Lam Julian Tang |
| author_sort | Nisha A. George |
| collection | DOAJ |
| description | We report a case of a 54 year old Sudanese lady admitted with dizziness, visual disturbance and collapse with nystagmus, ataxia, bilateral ptosis, and 3rd cranial nerve palsy on examination. CT and MRI scan of her head showed multiple areas of infarct. A lumbar puncture showed lymphocytosis and was positive for VZV. She was initiated on treatment with IV acyclovir but during the course of her admission, she had recurrent strokes and maintained VZV DNA positivity on repeated lumbar punctures despite being on prolonged treatment. She was diagnosed with refractory varicella encephalitis secondary to varicella zoster virus reactivation, likely resulting from recent rituximab therapy for systemic lupus erythematosus and a mixed connective tissue disorder. |
| format | Article |
| id | doaj-art-921795d1bb62468fbdf15657c7301183 |
| institution | OA Journals |
| issn | 2590-1702 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Infection in Practice |
| spelling | doaj-art-921795d1bb62468fbdf15657c73011832025-08-20T01:59:01ZengElsevierClinical Infection in Practice2590-17022024-11-012410039510.1016/j.clinpr.2024.100395Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximabNisha A. George0Melissa Haines1Vincent Lam2Julian Tang3Department of Infectious Disease, University Hospital of Leicester NHS Trust, Leicester Royal Infirmary, UKDepartment of Infectious Disease, University Hospital of Leicester NHS Trust, Leicester Royal Infirmary, UKDepartment of Radiology, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, UKClinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, UK; Respiratory Science, University of Leicester, Leicester, UK; Corresponding author at: Clinical Microbiology, 5/F Sandringham Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.We report a case of a 54 year old Sudanese lady admitted with dizziness, visual disturbance and collapse with nystagmus, ataxia, bilateral ptosis, and 3rd cranial nerve palsy on examination. CT and MRI scan of her head showed multiple areas of infarct. A lumbar puncture showed lymphocytosis and was positive for VZV. She was initiated on treatment with IV acyclovir but during the course of her admission, she had recurrent strokes and maintained VZV DNA positivity on repeated lumbar punctures despite being on prolonged treatment. She was diagnosed with refractory varicella encephalitis secondary to varicella zoster virus reactivation, likely resulting from recent rituximab therapy for systemic lupus erythematosus and a mixed connective tissue disorder.http://www.sciencedirect.com/science/article/pii/S2590170224000554 |
| spellingShingle | Nisha A. George Melissa Haines Vincent Lam Julian Tang Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximab Clinical Infection in Practice |
| title | Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximab |
| title_full | Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximab |
| title_fullStr | Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximab |
| title_full_unstemmed | Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximab |
| title_short | Refractory reactivated VZV encephalitis with vasculopathy secondary to rituximab |
| title_sort | refractory reactivated vzv encephalitis with vasculopathy secondary to rituximab |
| url | http://www.sciencedirect.com/science/article/pii/S2590170224000554 |
| work_keys_str_mv | AT nishaageorge refractoryreactivatedvzvencephalitiswithvasculopathysecondarytorituximab AT melissahaines refractoryreactivatedvzvencephalitiswithvasculopathysecondarytorituximab AT vincentlam refractoryreactivatedvzvencephalitiswithvasculopathysecondarytorituximab AT juliantang refractoryreactivatedvzvencephalitiswithvasculopathysecondarytorituximab |