Document 0366
 DOCN  M9440366
 TI    Acute varicella-zoster virus ventriculitis and meningo-myelo-radiculitis
       in acquired immunodeficiency syndrome.
 DT    9404
 AU    Chretien F; Gray F; Lescs MC; Geny C; Dubreuil-Lemaire ML; Ricolfi F;
       Baudrimont M; Levy Y; Sobel A; Vinters HV; Department de Pathologie
       (Neuropathologie), Hopital Henri; Mondor, Faculte de Medecine de
       Creteil, Universite Paris XII,; France.
 SO    Acta Neuropathol (Berl). 1993;86(6):659-65. Unique Identifier : AIDSLINE
       MED/94144349
 AB    A 30-year-old AIDS patient with no history of cutaneous eruption,
       presented with rapidly progressive flaccid paraplegia, hypoesthesia,
       urinary retention, moderate psychomotor slowing and fever (39.8 degrees
       C), leading to death within 1 week. CD4 count was 290/mm3. Cerebrospinal
       fluid contained 210 white blood cells and 238 mg/100 ml protein.
       Neuropathology revealed HIV encephalitis and diffuse ventriculitis with
       Cowdry type A inclusions in the ependymal cells. Extensive necrotic and
       hemorrhagic changes with marked recrotizing vasculitis involved the
       entire spinal cord and spinal roots. Immunocytochemistry revealed
       numerous inclusion bodies positive for varicella-zoster virus (VZV) and
       negative for cytomegalovirus (CMV) and herpes simplex virus type 1 and
       2, in ependymal cells, subpial glial cells, endothelial cells and
       Schwann cells. Electron microscopy confirmed herpes virus-like
       particles. In situ hybridization confirmed VZV genome in leptomeninges,
       brain, spinal cord and spinal roots. Comparable neuropathological
       findings and numerous VZV inclusion bodies were also found in the brain,
       spinal cord, and spinal roots of a 40-year-old AIDS patient who died
       from a fulminant ascending myeloradiculopathy previously reported as
       necrotizing vasculitis of the nervous system. Direct infection of the
       brain by VZV, in AIDS patients, has been shown to cause
       leukoencephalitis and cerebral non-inflammatory vasculopathies. Our
       observations demonstrate that, in AIDS patients, VZV infection of the
       central nervous system may also be responsible for
       meningo-myelo-radiculitis possibly secondary to ventriculitis as in CMV
       infection. The role of VZV in the pathogenesis of some AIDS-related
       vasculitides seems also very likely.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY  Adult  AIDS
       Dementia Complex/COMPLICATIONS/*PATHOLOGY  Brain/MICROBIOLOGY/*PATHOLOGY
       Female  Genome, Viral  Herpes Zoster/*COMPLICATIONS/PATHOLOGY
       Herpesvirus 3, Human/ISOLATION & PURIF  Human  In Situ Hybridization
       Magnetic Resonance Imaging  Male  Meninges/MICROBIOLOGY/*PATHOLOGY
       Radiculitis/COMPLICATIONS/*PATHOLOGY  Spinal
       Cord/MICROBIOLOGY/*PATHOLOGY  Spinal Nerve Roots/MICROBIOLOGY/*PATHOLOGY
       Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).