Open AccessSub-acute herpes simplex virus myelitis in a patient with esophageal cancer on chemo-radiation with 5-fluorouracil: a case report
Author(s) -
Pavani Samudrala,
Maria Teresa Cruz Carreras,
Mariela Blum Murphy,
Terry W. Rice
Publication year - 2018
Publication title -
acute medicine
Language(s) - English
Resource type - Journals
eISSN - 1747-4892
pISSN - 1747-4884
DOI - 10.52964/amja.0722
Subject(s) - medicine , myelitis , malignancy , esophageal cancer , transverse myelitis , herpes simplex virus , magnetic resonance imaging , acute transverse myelitis , dysphagia , cancer , radiology , gastroenterology , dermatology , spinal cord , immunology , virus , multiple sclerosis , psychiatry
No reported cases to date describe herpes simplex virus (HSV) myelitis in association with cancer and chemo-radiation. We report a case of sub-acute HSV myelitis in a 54-year-old man receiving chemo-radiation with 5-flourouracil for esophageal cancer who presented to the emergency department with increasing numbness in both lower limbs that gradually spread to waist level. Magnetic resonance imaging with gadobutrol contrast 1 week later showed transverse myelitis involving the dorsal columns. Radiation-induced myelitis was suspected, and the patient was initially treated with dexamethasone; however, CSF analysis revealed HSV myelitis. Treatment with antivirals resolved much of the numbness. HSV myelitis can be confused with complications of radiation or malignancy in patients presenting with focal neurological deficits.