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Biopsy-negative, varicella zoster virus (VZV)-positive giant cell arteritis, zoster, VZV encephalitis and ischemic optic neuropathy, all in one

2014; Elsevier BV; Volume: 343; Issue: 1-2 Linguagem: Inglês

10.1016/j.jns.2014.05.035

1878-5883

Tiago Teodoro, Maria A. Nagel, Ruth Geraldes, Teresa White, Ravi Mahalingam, P. P. Batista, Mary Wellish, José Pimentel, Nelly Khmeleva, Anna Heintzman, Luí­sa Albuquerque, Philip J. Boyer, Alexander Choe, Ana Rita Peralta, Don Gilden,

Retinal and Optic Conditions

A 72-year-old man developed clinical features of giant cell arteritis (GCA) and ipsilateral ophthalmic-distribution zoster, followed within 2 weeks by VZV encephalitis and 2 months later by ischemic optic neuropathy. Temporal artery biopsy was histopathologically negative for GCA, but contained VZV antigen and VZV DNA in multiple non-contiguous (skip) areas. The collective clinical and laboratory findings revealed a remarkably close temporal association of zoster, multifocal VZV vasculopathy with temporal artery infection, biopsy-negative VZV-positive GCA and VZV encephalitis.