BRAIN-STEM ENCEPHALITIS DUE TO VARICELLA-ZOSTER VIRUS IN A PATIENT WITH AIDS

We describe a patient infected with human immunodeficiency virus (HIV) who had localized brain stem encephalitis due to varicella-zoster vir us (VZV) and no cutaneous eruption. Diagnosis of the infection was bas ed on the presence of Cowdry type A intranuclear inclusions in neurons , astrocytes, and oligodendrocytes positive for VZV (as shown by immun ochemical staining), Although this infection is rare, we demonstrate t he need for clinicians to include VZV infection in the differential di agnosis of rapidly progressive multiple cranial nerve palsies in HIV-i nfected patients, particularly because specific treatment for VZV infe ction is effective and relatively safe.