CENTRAL-NERVOUS-SYSTEM HERPESVIRUS-INFECTION IN SYSTEMIC LUPUS-ERYTHEMATOSUS - DIAGNOSIS BY ENDORETINAL BIOPSY

A 31-year-old woman with systemic lupus erythematosus (SLE) developed meningoencephalitis, followed by transverse myelitis. The clinical pic ture was otherwise not consistent with a lupus flare. Extensive diagno stic evaluation was unrevealing. Acute visual loss ensued, associated with an unusual pattern of retinitis. Endoretinal biopsy established t he diagnosis of herpesvirus infection. Reinstitution of antiviral ther apy, and optic nerve sheath decompression, led to resolution of neurol ogic deficits and partial return of vision. Our report is the first th at describes a patient with SLE with herpes meningoencephalitis, trans verse myelitis, and rapidly progressive outer retinal necrosis, diagno sed antemortem by endoretinal biopsy, and successfully treated with ac yclovir and optic nerve fenestration.