August 1976

Viral Ascending Radiculomyelitis With Severe Hypoglycorrachia

Author Affiliations

From the departments of medicine and microbiology, Michael Reese Hospital and Medical Center, and the Department of Medicine, the University of Chicago, Pritzker School of Medicine, Chicago. Dr Naraqi is now with the University of Illinois, Abraham Lincoln School of Medicine, Chicago.

Arch Intern Med. 1976;136(8):933-935. doi:10.1001/archinte.1976.03630080067020

Infections with viruses of the herpes group have been associated with ascending radiculomyelitis, polyneuronitis, and myelitis.1-8 Since the avaliability of modern diagnostic serologic and viral isolation techniques, cytomegalovirus (CMV) has been most frequently cited in association with these neurologic diseases.1.2.9-12 Epstein Barr virus (EBV),13 herpes simplex virus (HSV),3.7 and Herpesvirus varicella-herpes zoster (HZ)6.8 have also been cited as causal agents.

We report a patient with ascending radiculomyelitis associated with rising antibody titers to CMV. Previously reported cases of CMV radiculomyelitis and radiculoneuronitis have been accompanied by albuminocytologic dissociation of the cerebrospinal fluid (CSF) or mild pleocytosis. In contrast, our patient had a transient marked polymorphonuclear pleocytosis of the CSF and hypoglycorrachia that were associated with a nonthrombocytopenic purpuric rash, suggesting that both the rash and neurologic disease were consequent to vasculitis produced by the virus.

PATIENT SUMMARY Clinical Findings  A 52-year-old woman who was unable

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