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Herpes varicella zoster encephalitis in immunocompromised patients

From the Department of Neurology (Dr. Weaver), Albany Medical Center, Albany; and the Departments of Pathology (Dr. Rosenblum) and Neurology (Dr. DeAngelis), Memorial Sloan-Kettering Cancer Center, New York, NY. Presented in part at the 46th annual meeting of the American Academy of Neurology; Washington, DC; May 1994.

Address correspondence and reprint requests to Dr. Lisa M. DeAngelis, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021.

The authors describe specific MRI features that suggest the diagnosis of varicella zoster encephalitis. MRI initially revealed discrete, subcortical, nonenhancing lesions that coalesced and developed enhancement. Gray matter involvement was seen later. Autopsy revealed spherical lesions of demyelination and hemorrhagic cavitation confirmed as varicella zoster encephalitis. Characteristic MR features may suggest the diagnosis of varicella zoster encephalitis, enabling definitive diagnostic testing and early institution of antiviral treatment.

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