by Steven C. Cramer, MD, Alan Segal, MD*, Ronald Hamilton, MD+,
Jeremy Schmahmann, MD*, and M. Joe Ma, MD°
Published: 14 May 1996
This case report describes the clinical features and postmortem
diagnosis of varicella zoster virus (VZV) leukoencephalitis in a
patient with acquired immunodeficiency syndrome (AIDS) who was
taking suppressive doses of acyclovir for previous disseminated
VZV infection. With more patients attaining increased survival
in the later stages of AIDS, the incidence of VZV leukoencephalitis
will likely rise. Because this is a treatable condition, clinical
features of diagnostic value are reviewed. Key features include
a history of deep, disseminated, or recurrent VZV infection; rapid
progression; very low CD_4 count; and a tendency for hemorrhagic
transformation on computed tomography (CT) of the head. The
recurrence of VZV infection in a patient taking twice-daily oral
acyclovir suggests that an alternate suppressive regimen may be needed
after a severe VZV infection in an immunocompromised patient.
Key words: VZV, leukoencephalitis, AIDS, hemmorrhage, acyclovir
Leukoencephalitis Due to Varicella Zoster Virus: Report of a Case
and Review of Clinical Features (1:2)
by Steven C.
Cramer, M.D. et al.
