Zoster myelitis: Improvement with antiviral therapy in two cases
Zoster myelitis: Improvement with antiviral therapy in two cases
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DOI：
10.1212/wnl.47.4.929
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发表时间：
1996-10-01
期刊：
影响因子：
9.9
通讯作者：
Houff, S
中科院分区：
文献类型：
--
作者：
deSilva, SM;Mark, AS;Houff, S
本文报告两例获得性免疫缺陷综合征（艾滋病）和疱疹病毒测试仪脊髓病。患者1在T-8分布测试仪出现之前出现T-8肌痉挛，随后出现颈椎病。脑脊液中存在水痘试验病毒（VZV）抗体。他从未接受过类固醇或其他免疫抑制药物，在静脉注射阿昔洛韦治疗后，他的病情得到了显著改善。第二个病人有一个快速进行性的肌肉萎缩与瘫痪的双腿。在他的CSF中检测到VZV DNA和VZV抗体，尽管停用地塞米松和早期阿昔洛韦治疗失败，但仍成功地用泛昔洛韦治疗。这些病例支持免疫抑制宿主中VZV脊髓病是由病毒入侵引起的观点。脑脊液抗病毒抗体和聚合酶链反应检测VZV DNA有助于确诊。建议积极抗病毒治疗。
This report describes two patients with acquired immunodeficiency syndrome (AIDS) and herpes tester myelopathy. Patient one had a T-8 myelitis that preceded the onset of T-8-distribution tester and was followed by cervical myelopathy. Antibody to varicella tester virus (VZV) was present in the CSF. He never received steroids or other immunosuppressive drugs, and his condition improved dramatically after treatment with intravenous acyclovir. The second patient had a rapidly progressive myelitis with paralysis of both legs. Detection of VZV DNA and antibody to VZV in his CSF led to successful treatment with famciclovir despite discontinuation of dexamethasone and earlier treatment failure with acyclovir. These cases support the idea that VZV myelopathy in the immunosuppressed host is caused by virus invasion. CSF analysis for antiviral antibody and for VZV DNA by polymerase chain reaction are helpful in establishing the diagnosis. Aggressive antiviral therapy is advised.