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Master Thesis

Complications neuroméningées du VZV : caractéristiques et facteurs pronostiques chez 72 patients avec PCR positive dans le LCR

Abstract : Background : VZV is one of the first three etiologies of viral meningitis and meningoencephalitis with mild to severe sequelae. The prognostic factors of its evolution are not known and its management is not codified.
Methods: this is a multicenter retrospective study of all VZV PCRs positive by lumbar puncture, between 2011 and 2018 in 20 french departments (Paris). All patients were contacted to update followup data including recovery and disability assessed by the difference between Rankin scores before and after the complication.
Results : 72 patients were included (34 aseptic meningitis, 15 central and 15 peripheral disorders). Recovery was complete in 43% of cases (66% of meningitis), the average Rankin delta was 0.7 (0.3 for meningitis), VZV-related mortality was 12% (0% of meningitis). In multivariate analysis, age and CSF protein were significantly associated with disability in aseptic meningitis (P <0.001 and P = 0.015 respectively). There was a trend for IFN alpha in CSF and CRP as prognostic factors for poorer recovery.
Conclusion : the neurological complications of VZV are potentially severe. Aseptic meningitis evolves mainly favorably. Age and elevated CSF protein are associated with poorer recovery of simple meningitis. A prospective study is needed to codify the treatment recommendations.
Document type :
Master Thesis
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Submitted on : Monday, December 6, 2021 - 3:17:49 PM
Last modification on : Tuesday, February 1, 2022 - 3:39:30 AM
Long-term archiving on: : Monday, March 7, 2022 - 7:10:34 PM

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Tiphaine Thillaye Du Boullay-Lenfant. Complications neuroméningées du VZV : caractéristiques et facteurs pronostiques chez 72 patients avec PCR positive dans le LCR. Médecine humaine et pathologie. 2019. ⟨dumas-03467482⟩

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