**5.3 Case 4: cerebral infarction associated with granulomatous vasculitis**

The patient was a 52-year-old woman with systemic lupus erythematosus (SLE) who exhibited altered levels of consciousness during immunotherapy for SLE. The CSF test showed pleocytosis, an elevated protein level, and positivity for VZV DNA, and the patient was then diagnosed with VZV meningoencephalitis. Brain MRI showed cerebral infarction in the left cerebral white matter, and MR angiogram showed stenosis of the left middle cerebral artery.
