Three atopic siblings with sequential primary herpes simplex virus (HSV) infection on their eczeatous lesions following their father's recurrent herpes labialis were presented. Eczema herpeticum was diagnosed on the basis of their characteristic grouped umbilicated vesicles superimposed on pre-existing atopic eczematous lesions. HSV type 1 was identified from the three patients' Tzanck smears and viral isolation of vesicular contents by monoclonal antibodies. The skin lesions faded spontaneously in the first case, although this elder brother did not receive any antiviral treatment. Later, he developed mild recurrence of skin lesions on his extremities. His younger twin sisters were treated with systemic acyclovir and no recurrences occurred during 2 years of follow up. All of them developed anti-HSV antibody about 7 to 14 days after clinical onset. Acyclovir seems to be an effective antiviral agent in treating eczema herpeticum and reducing subsequent recurrences after primary herpes simplex virus infection.
BACKGROUND
Primary spinal cord (PSC) glioblastoma (GB) is an extremely rare but fatal primary tumor of the central nervous system and associated with a poor prognosis. While typical tumor imaging features are generally easy to recognize, glioblastoma multiforme can have a wide range of imaging findings. Atypical GB is often misdiagnosed, which usually delays the optimal time for treatment. In this article, we discuss a clinical case of pathologically confirmed PSC GB under the guise of benign tumor imaging findings, as well as the most recent literature pertaining to PSC GB.
CASE SUMMARY
A 70-year-old female complained of limb weakness lasting more than 20 d. Irregular masses were observed inside and outside the left foramina of the spinal canal at C7-T1 on medical imaging. Based on the imaging features, radiologists diagnosed the patient with schwannoma. Tumor resection was performed under general anesthesia. The final histopathological findings revealed a final diagnosis of PSC GB, world health organization Grade IV. The patient subsequently underwent a 4-wk course of radiotherapy (60 Gy in 20 fractions) combined with temozolomide chemotherapy. The patient was alive at the time of submission of this manuscript.
CONCLUSION
Atypical GB presented unusual imaging findings, which led to misdiagnosis. Therefore, a complete recognition of imaging signs may facilitate early accurate diagnosis.
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