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Varicella Zoster Virus Central Nervous System Immune Reconstitution Inflammatory Syndrome Presenting in a Child

Iro, Mildred A. MBBS, MRCPCH*; Kirkham, Fenella J. MA, MB, BChir, FRCPCH; Macdonald, Jason H. M. MBBS, MRCP, FRCR; Tebruegge, Marc DTM&H, DLSHTM, MRCPCH, MSc, MD§¶‖; Faust, Saul N. MA, MBBS, MRCPCH, PhD, FHEA§¶ **; Patel, Sanjay V. MA, MSc, MBBS, MRCPCH

The Pediatric Infectious Disease Journal: November 2013 - Volume 32 - Issue 11 - p 1283–1284
doi: 10.1097/INF.0b013e31829aa4fc
Brief Reports

A HIV-positive child presented with acute onset of right hemiplegia, facial palsy and dysphasia 4 weeks after commencing highly active antiretroviral therapy. Magnetic resonance imaging confirmed a left-sided cerebral infarct. Cerebrospinal fluid polymerase chain reaction was positive for varicella zoster virus. This is the first reported pediatric case of varicella zoster virus–related immune reconstitution inflammatory syndrome involving the central nervous system.

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From the *Oxford Vaccine Group, Department of Pediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford; Department of Pediatric Neurology and Neuroradiology, University Hospital Southampton NHS Foundation Trust; §Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton; Department of Pediatric Immunology and Infectious Diseases, Southampton Children’s Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Department of Pediatrics, The University of Melbourne, Parkville, Australia; and **NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.

Accepted for publication May 7, 2013.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Sanjay Patel, MA, MSc, MBBS, MRCPCH, Consultant in Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Division of Women & Children, Mailpoint 43, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD. E-mail:

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© 2013 by Lippincott Williams & Wilkins, Inc.