Stroke as a complication of varicella tester central nervous system infection is reported in both adults and children.(1,2) In addition, one prior report of pediatric acquired immunodeficiency syndrome (AIDS)-associated varicella tester resulted in stroke and death.(3) We report a second child with AIDS-associated varicella tester who developed a subacute and progressive vasculopathy resulting in death. The diagnosis was confirmed with neuroimaging including proton magnetic resonance spectroscopy (MRS), magnetic resonance angiography (MRA), and varicella DNA polymerase chain reaction in the cerebrospinal fluid.