Difficulties in the diagnosis of delayed contralateral hemiparesis due to Varicella-Zoster Virus in an HIV-positive patient

摘要

Herpes zoster is much more frequent among HIV-infected patients compared to immunocompetent populations.1 Delayed contralateral hemiparesis (DCH) is a rare but serious complication that can occur weeks to months after an episode of herpes zoster ophthalmicus (HZO).1 Previous varicella-zoster virus (VZV) infection could be associated with the pathomechanism in cases of central nervous system (CNS) involvement, despite negative VZV-DNA in PCR of the cerebrospinal fluid (CSF).2 Herein, we describe the case of an HIV-positive patient who developed left hemiparesis due to cerebral angiitis, as evident from MRI images, four months after HZO on the right side.