Subject(s)
Lymphoma, Large B-Cell, Diffuse/diagnosis , Spinal Cord Ischemia/diagnosis , Spinal Cord/diagnostic imaging , Vascular Neoplasms/diagnosis , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Hypesthesia/diagnosis , Hypesthesia/etiology , Lymphoma, Large B-Cell, Diffuse/complications , Lymphoma, Large B-Cell, Diffuse/drug therapy , Magnetic Resonance Imaging , Male , Paraparesis/diagnosis , Paraparesis/etiology , Spinal Cord/blood supply , Spinal Cord Ischemia/etiology , Spinal Cord Ischemia/physiopathology , Vascular Neoplasms/complications , Vascular Neoplasms/drug therapyABSTRACT
Acute cerebellitis is a well recognized complication of varicella zoster virus (VZV) infection in children. It has been described in adults in the setting of virus reactivation with a preceding herpes zoster rash, but it is exceedingly rare in adults who are not elderly or immunocompromised, particularly in the absence of a rash. To our knowledge, there has been only one reported case of acute cerebellitis in an immunocompetent adult less than age 65 with virological confirmation of acute VZV infection. We describe a 59-year-old immunocompetent man who presented with acute truncal ataxia without rash and was diagnosed with VZV cerebellitis, supported by anti-VZV IgM and anti-VZV IgG antibodies in the serum and a positive VZV polymerase chain reaction in cerebrospinal fluid. He had robust improvement with intravenous acyclovir treatment and was free of neurologic disability at two month follow-up. This case highlights the importance of virological evaluation in patients with acute ataxia, even in the absence of typical features of infection.
