Varicella-zoster virus-associated polyradiculoneuritis with concomitant herpes zoster eruption: a case report

Shoji, Hiroshi; Fukushima, Y; Sakoda, Yoritake; Abe, Takanobu; Oguri, Shuichi; Baba, Masayuki

doi:10.5692/clinicalneurol.cn-001302

Cited by 6 publications

(9 citation statements)

References 3 publications

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“…We experienced three cases of aseptic meningitis by VZV and one case of VZV myelitis after HZ dermatitis during treatment with amenamevir for HZ in various immunological backgrounds (Table 1 ). Table 2 summarizes six HZ cases treated with amenamevir with CNS complications that were previously reported [ 2 - 6 ]. While three cases in our report are regarded as immunocompromised hosts (two cases were taking immunosuppressive drugs, and one case had sigmoid colon cancer as an underlying disease), one case was immunocompetent.…”

Section: Discussionmentioning

confidence: 99%

Varicella-Zoster Meningitis and Myelitis After Herpes Zoster Dermatitis Treatment With Amenamevir: A Case Series and Literature Review

Tada,

Kaito,

Watanabe

et al. 2024

Cureus

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Varicella-zoster virus (VZV), known for causing chickenpox, establishes latent infections in neural tissues. Reactivation of VZV can lead to herpes zoster (HZ) and various neurological complications. In this report, we present four cases of VZV meningitis and myelitis following amenamevir treatment for HZ dermatitis with positive VZV DNA in cerebrospinal fluid (CSF) revealed by polymerase chain reaction (PCR). Three of them were considered immunocompromised hosts given the fact that two of these patients were taking immunosuppressive drugs for rheumatoid arthritis, and one patient had a history of sigmoid colon cancer (four months after resection). After HZ onset, amenamevir, which has poor CSF transfer, was prescribed for all the patients, and all of them developed central nervous complications by VZV (meningitis in three cases and myelitis in one case) confirmed by PCR. All the patients were treated with acyclovir, which has a higher CSF transfer, and fully recovered. We speculate that amenamevir might have failed to prevent VZV infection in the central nervous system (CNS) and think that consideration should be given to administering acyclovir in preference to amenamevir for ΗΖ patients at high risk of CNS VZV infection, such as immunocompromised hosts.

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Section: Discussionmentioning

confidence: 99%

Varicella-Zoster Meningitis and Myelitis After Herpes Zoster Dermatitis Treatment With Amenamevir: A Case Series and Literature Review

Tada,

Kaito,

Watanabe

et al. 2024

Cureus

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“…One report suggested the efficacy of amenamevir against VZV infection intractable to treatment with valacyclovir in an immunocompromised host ( 16 ). Another suggested treatment efficacy against VZV infection with polyradiculoneuritis in an immunocompromised patient who was treated with a combination of amenamevir and acyclovir ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Amenamevir for the Treatment of Disseminated Herpes Zoster Complicated with Probable Varicella-zoster Pneumonia in an Immunocompromised Patient

et al. 2022

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We herein report the case of a 78-year-old woman who was diagnosed as having disseminated herpes zoster (DHZ) complicated with probable varicella-zoster pneumonia during maintenance therapy for microscopic polyangiitis. Because the patient had severe renal dysfunction, amenamevir administration was started to avoid any neurotoxicity of acyclovir, which is suggested to be optimal for treatment. It ameliorated her symptoms without any adverse events. This is the first report suggesting the efficacy of amenamevir in the treatment of severe herpes zoster infection with coexisting DHZ and probable varicella-zoster pneumonia. Amenamevir could thus be a treatment option for severe varicella zoster virus infections.

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“…Among HZ cases, the rate of complication with central nervous system infection is 12%, and 76% of these patients with central nervous system infection exhibit a skin rash that is most commonly located near the trigeminal nerve ( 12 ). Previous Japanese HZ cases treated with amenamevir and complicated by central nervous system infection are summarized in Table ( 9 , 13 , 14 ). Half of them, including our case, had HZ in the region of the trigeminal nerve.…”

Section: Discussionmentioning

confidence: 99%

Aseptic Meningitis after Amenamevir Treatment for Herpes Zoster in the First Branch of the Trigeminal Nerve

et al. 2022

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Amenamevir has been approved for the treatment of herpes zoster (HZ); however, its therapeutic efficacy against central nervous system (CNS) infection may be insufficient due to its low spinal fluid permeability. We herein report a case of aseptic meningitis in a 91-year-old Japanese man treated with amenamevir for HZ in the trigeminal nerve region. Several cases of CNS infection have been reported in patients receiving amenamevir treatment for HZ. Patients with CNS complications often have skin rashes near the trigeminal region. Thus, we should be alert for signs of CNS infection when administering amenamevir to patients with such rashes.

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Varicella-zoster virus-associated polyradiculoneuritis with concomitant herpes zoster eruption: a case report

Cited by 6 publications

References 3 publications

Varicella-Zoster Meningitis and Myelitis After Herpes Zoster Dermatitis Treatment With Amenamevir: A Case Series and Literature Review

Varicella-Zoster Meningitis and Myelitis After Herpes Zoster Dermatitis Treatment With Amenamevir: A Case Series and Literature Review

The Efficacy of Amenamevir for the Treatment of Disseminated Herpes Zoster Complicated with Probable Varicella-zoster Pneumonia in an Immunocompromised Patient

Aseptic Meningitis after Amenamevir Treatment for Herpes Zoster in the First Branch of the Trigeminal Nerve

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