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Reactivation of type 1 herpes simplex virus and varicella zoster virus in an immunosuppressed patient with acute peripheral facial weakness.
- Source :
-
Journal of the neurological sciences [J Neurol Sci] 2012 Feb 15; Vol. 313 (1-2), pp. 193-5. Date of Electronic Publication: 2011 Sep 15. - Publication Year :
- 2012
-
Abstract
- We describe a 26-year-old man treated with azathioprine for myasthenia gravis who developed acute left-sided peripheral facial weakness. Brain magnetic resonance imaging (MRI) revealed enhancement in the left geniculate ganglion and in the intracanalicular and tympanic segments of the facial nerve. Analysis of cerebrospinal fluid (CSF) and serum revealed intrathecal synthesis of anti-varicella zoster virus (VZV) IgG antibody. Although previous analyses of saliva, blood mononuclear cells, serum antibodies, middle ear fluid, and auricular and geniculate zone skin scrapings have shown that a small but definite proportion of patients with idiopathic peripheral facial palsy ("Bell's palsy") have the Ramsay Hunt syndrome zoster sine herpete (RHS ZSH), this is the first confirmation of RHS ZSH by intrathecal synthesis of anti-VZV IgG antibody. In addition, herpes simplex virus (HSV)-1 DNA was found in saliva of the patient on 3 consecutive days. Simultaneous reactivation of two alphaherpesviruses (HSV-1 and VZV) in our immunosuppressed patient underscores the need to consider opportunistic infection as a cause of facial weakness.<br /> (Copyright © 2011 Elsevier B.V. All rights reserved.)
- Subjects :
- Acute Disease
Adult
Facial Paralysis diagnosis
Facial Paralysis virology
Herpes Simplex diagnosis
Herpes Zoster diagnosis
Humans
Male
Recurrence
Virus Activation physiology
Facial Paralysis cerebrospinal fluid
Herpes Simplex cerebrospinal fluid
Herpes Zoster cerebrospinal fluid
Herpesvirus 1, Human physiology
Herpesvirus 3, Human physiology
Immunocompromised Host
Subjects
Details
- Language :
- English
- ISSN :
- 1878-5883
- Volume :
- 313
- Issue :
- 1-2
- Database :
- MEDLINE
- Journal :
- Journal of the neurological sciences
- Publication Type :
- Academic Journal
- Accession number :
- 21924743
- Full Text :
- https://doi.org/10.1016/j.jns.2011.08.040