Case 117. VZV encephalitis in AIDS (40 y-o M)
Fatal necrotizing encephalitis manifested after healing of herpes zoster
Key words : varicella-zoster virus, necrotizing encephalitis, AIDS
opportunistic infection
Massive and fused necrosis is seen mainly in the cerebral cortex of the left hemisphere (a frontal section after formalin fixation).   Intranuclear inclusions, Cowdry's type A, are formed in neurons located in the edematous neuropil background (HE). Histologic features of VZV encephalitis are indistinguishable from those of HSV encephalitis.
A monoclonal antibody to GP-1 antigen of VZV demonstrates membrane positivity in the infected area (immunostaining). GP-1 antigen is not expressed in the intranuclear inclusions.