Volume 2015, Issue 2

Abstract

We describe an elderly gentleman with end stage renal disease on haemodialysis who presented with ophthalmic zoster infection and was discharged on oral acyclovir. He presented again a few days later with confusion and expressive dysphasia. Differential diagnosis was mainly between varicella-zoster virus (VZV) associated encephalitis versus acyclovir toxicity. Cerebrospinal fluid analysis confirmed the diagnosis of VZV associated encephalitis and the patient was treated with intravenous acyclovir and steroids with full recovery back to pre-admission neurological status.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2015.19
2016-01-26
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2015/2/qmj.2015.19.html?itemId=/content/journals/10.5339/qmj.2015.19&mimeType=html&fmt=ahah

References

  1. Arvin A. Aging, immunity, and the varicella-zoster virus. N Engl J Med. 2005; 352:22:22662267.
    [Google Scholar]
  2. Cheung WC, Yuen KY, Chang CM, Cheng KP. Herpes zoster associated encephalitis in dialysis patients. J Infect. 1991; 23:2:169174.
    [Google Scholar]
  3. Heye N, Terstegge K, Gosztonyi G. Vasculitic, hypoxic-ischemic leukoencephalopathy. Clin Neurol Neurosurg. 1994; 96:2:156160.
    [Google Scholar]
  4. Sigaloff KC, de Fijter CW. Herpes zoster-associated encephalitis in a patient undergoing CAPD: Case report and literature review. Perit Dial Int. 2007; 27:4:391394.
    [Google Scholar]
  5. Mesar I, Basic-Jukic N, Hudolin T, Katalinic L, Kes P. Varicella zoster virus reactivation in hemodialysis patients: Manifestations, treatment, complications and outcome. Acta Clin Croat. 2011; 50:4:549552.
    [Google Scholar]
  6. Kato S, Chmielewski M, Honda H, Pecoits-Filho R, Matsuo S, Yuzawa Y, Tranaeus A, Stenvinkel P, Lindholm B. Aspects of immune dysfunction in end-stage renal disease. Clin J Am Soc Nephrol. 2008; 3:5:15261533.
    [Google Scholar]
  7. Kuo CC, Lee CT, Lee IM, Ho SC, Yang CY. Risk of herpes zoster in patients treated with long-term hemodialysis: A matched cohort study. Am J Kidney Dis. 2012; 59:3:428433.
    [Google Scholar]
  8. Low LL, Vasanwala FF, Suhail SM. Varicella encephalitis and pneumonia in a patient with end stage renal failure. Asia Pac Fam Med. 2014; 13:1:4.
    [Google Scholar]
  9. de Knegt RJ, van der Pijl H, van Es LA. Acyclovir-associated encephalopathy, lack of relationship between acyclovir levels and symptoms. Nephrol Dial Transplant. 1995; 10:9:17751777.
    [Google Scholar]
  10. Gilden DH, Kleinschmidt-DeMasters BK, LaGuardia JJ, Mahalingam R, Cohrs RJ. Neurologic complications of the reactivation of varicella-zoster virus. N Engl J Med. 2000; 342:9:635645.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2015.19
Loading
/content/journals/10.5339/qmj.2015.19
Loading

Data & Media loading...

Keyword(s): acyclovir toxicityencephalitishaemodialysis and varicella zoster

Most Cited Most Cited RSS feed