Post varicella zoster virus myelitis in immunocompetent patients

Abstract

We report 2 immunocompetent patients with myelitis. The first was a 55-year old man who developed myelitis after intercostal herpes zoster. The second was a 19-year-old boy who presented with myelopathy after varicella infection. Varicella-zoster virus (VZV) myelitis was diagnosed based on the close temporal relationship between rash and onset of clinical symptoms, and by the elevated rate of anti-VZV IgG in the CSF without oligoclonal bands in the first case, and presence of VZV DNA in the second. The course was favorable after a 3-day course of corticosteroids and 3 weeks of acyclovir. Varicella-zoster virus myelitis is uncommon; it affects essentially immunodepressed patients. We highlight the importance of considering the possibility of VZV myelitis, even in immunocompetent patients. The combination of corticoids and acyclovir must be instituted, quickly, to improve functional outcome.