Parainfectious Transverse Myelitis secondary to Varicella Zoster Virus

Abstract

Varicella zoster virus is a human herpes virus that causes chickenpox and herpes zoster. Varicella zoster virus leads to numerous complications of the central and peripheral nervous systems. Transverse myelitis is a disorder characterized by focal inflammation of the spinal cord and results in loss of motor and sensory function below the level of injury. Transverse myelitis caused by Varicella zoster virus reactivation is rare in immunocompetent patients. Herein, we report a case of transverse myelitis caused by Varicella zoster virus in an immunocompetent young patient. A 33 years gentleman was admitted to our hospital with complaints of multiple pleomorphic skin lesions and fever for 10 days, unable to pass urine on his will for four days and weakness of bilateral lower limbs for three days. MRI spine showed long segment ill-defined mild T2 hyper intensity noted in the spinal cord along the visible portion of lower thoracic vertebra. The patient was treated with steroids and Acyclovir.He recovered completely in one month after discharge. Prompt clinical diagnosis with early use of antiviral and anti-inflammatory treatment is important for good outcome of disease in resource limited country like Nepal.