Myelitis due to Varicella-Zoster Infection in an Adult Immunocompetent Patient at Yalgado Ouedraogo University Teaching Hospital (Burkina Faso)

Abstract

Background: Varicella Zoster Virus (VZV) is a ubiquitous virus and is causing both diseases of varicella and herpes zoster. VZV reactivation may lead to neurological complications, including transverse myelitis. However, transverse myelitis caused by VZV reactivation is rare in immunocompetent patients. Case presentation: We reported a case of transverse myelitis caused by VZV in an immunocompetent young patient. A 42-year-old man was presented to the Neurology department in June 2019 with the complaints of cutaneous rash, lower limbs weakness and anal and urinary incontinence. The neurological manifestations occurred at twelve days after cutaneous rash. Spine MRI showed extensive intramedullary T2 hypersignal of C6 to C7. White blood cell showed hyperleucocytosis. Cerebrospinal fluid (CSF) showed leukocytosis (40 cells/μL) with increased levels of protein (1.134 g/l). CSF culture for bacteria and fungi were negative. The patient was treated with oral acyclovir, corticotherapy and functional rehabilitation. Complete recovery occurred after 4 weeks of treatment. Conclusions: Transverse VZV myelitis in an adult immunocompetent patient following cutaneous rash is extremely rare in our context. Clinical outcome was favorable after recommended dose of acyclovir, corticotherapy and rehabilitation.