Sub-acute herpes simplex virus myelitis in a patient with esophageal cancer on chemo-radiation with 5-fluorouracil: a case report | Zendy

Pavani Samudrala | Zendy; Maria Teresa Cruz Carreras | Zendy; Michael Murphy | Zendy; Terri Rice | Zendy

Open Access

Sub-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,

Michael Murphy,

Terri Rice

Publication year - 2018

Publication title -

acute medicine journal

Language(s) - English

Resource type - Journals

eISSN - 1747-4892

pISSN - 1747-4884

DOI - 10.52964/amja.0722

Subject(s) - myelitis , medicine , malignancy , transverse myelitis , esophageal cancer , dysphagia , acute transverse myelitis , herpes simplex virus , magnetic resonance imaging , gastroenterology , cancer , radiology , dermatology , spinal cord , immunology , multiple sclerosis , virus , 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.

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