4.0 Article

Central nervous system-immune reconstitution inflammatory syndrome presenting as varicella zoster virus-mediated vasculitis causing stroke

Journal

INTERNATIONAL JOURNAL OF STD & AIDS
Volume 25, Issue 9, Pages 683-685

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/0956462413518501

Keywords

HIV; AIDS; opportunistic infection; central nervous system; immune reconstitution inflammatory syndrome; IRIS; varicella zoster virus; herpes zoster; stroke; cerebral ischaemia; vasculitis; VZV vasculopathy

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Varicella zoster virus (VZV)-mediated vasculitis is a rare cause of stroke, but should be considered in HIV patients where vasculitis can occur in association with central nervous system - immune reconstitution inflammatory syndrome (CNS-IRIS). A literature search revealed 7 reports of VZV vasculitis over the years with no unifying management strategy, highlighting the difficulty in managing rare conditions in the absence of clear guidelines. This is the first documented case of VZV-mediated vasculitis presenting as stroke in the United Kingdom. Our patient made a full recovery with multidisciplinary input from HIV, neurology and radiology specialists.

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