Cerebral Venous Thrombosis and Acute Pulmonary Embolism following Varicella Infection
  • Rashid Khan
    Department of Internal Medicine, Belhoul Speciality Hospital, Dubai, UAE
  • Yasmeen Ajaz
    Department of Internal Medicine, Belhoul Speciality Hospital, Dubai, UAE
  • Anoop Kumar Pandey
    Department of Radiology, Belhoul Speciality Hospital, Dubai, UAE
  • Khalid AlSaffar
    Department of Neurology, Belhoul Speciality Hospital, Dubai, UAE
  • Sunil Roy Thottuvelil Narayanan
    Department of Cardiology, Belhoul Speciality Hospital, Dubai, UAE

Keywords

Venous thrombosis, pulmonary embolism, varicella infection, protein S deficiency, hypercoagulable state

Abstract

Varicella infection is caused by varicella-zoster virus (VZV) and commonly presents as a self-limiting skin manifestation in children. VZV also causes cerebral arterial vasculopathy and antibody-mediated hypercoagulable states leading to thrombotic complications in children, although there are very few such reports in adults. Postulated causal factors include vasculitis, direct endothelial damage, or acquired protein S deficiency secondary to molecular mimicry. These induced autoantibodies to protein S could lead to acquired protein S deficiency and produce a hypercoagulable state causing venous sinus thrombosis. Here we report the case of a 26-year-old man who presented with cortical venous sinus thrombosis and acute pulmonary embolism following varicella infection. Both conditions responded to anticoagulation treatment.

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References

  • Rabah F, El-Banna N, Abdel-Baki M, Beshlavi I, Macaraig D, Bhuyan D, et al. Postvaricella thrombosis-report of two cases and literature review. Pediatr Infect Dis J 2012;31:985–987.

  • Gayathri K, Ramalingam PK, Santhakumar R, Manjunath BV, Karuppuswamy N, Vetriveran B, et al. Cerebral sinus venous thrombosis as a rare complication of primary varicella zoster virus infection. J Assoc Physicians India 2016;64:74–76.

  • Shrivastava K Mugundhan, Sundaresan N, Senthilkumar P. Cerebral venous thrombosis following varicella infection. J Assoc Physicians India 2016;64:68–69.

  • Sardana V, Mittal LC, Sharma D, Khandelwal G. Acute venous sinus thrombosis after chickenpox infection. J Assoc Physicians India 2014;62:741–743.

  • Ziebold C, Von Kries R, Lang R, Weigl J, Schmitt HJ. Severe complications of varicella in previously healthy children in Germany: a 1-year survey. Pediatrics 2001;108:e79.

  • Paul G, Paul BS, Singh G. Unseen face of varicella-zoster infection in adults. Indian J Crit Care Med2016;20:731–734.

  • Siddiqi SA, Nishat S, Kanwar D, Ali F, Azeemuddin M, Wasay M. Cerebral venous sinus thrombosis: association with primary varicella zoster virus infection. J Stroke Cerebrovasc Dis 2012;21:917.

  • Eidelberg D, Sotrel A, Horoupian DS, Neumann PE, Pumarola-Sune T, Price RW. Thrombotic cerebral vasculopathy associated with herpes zoster. Ann Neurol 1986;19:7–14.

  • Nagel MA, Gilden D. Update on varicella zoster virus vasculopathy. Curr Infect Dis Rep 2014;16:407.

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    Published: 2019-09-20
    Issue: Vol 6 No 10 (view)

    How to cite:
    1.
    Khan R, Ajaz Y, Pandey AK, AlSaffar K, Narayanan SRT. Cerebral Venous Thrombosis and Acute Pulmonary Embolism following Varicella Infection. EJCRIM 2019;6 doi:10.12890/2019_001171.