Infection of the central nervous system caused by varicella zoster virus reactivation: a retrospective case series study

Becerra, Juan Carlos Lozano; Sieber, R.; Martinetti, Gladys; Costa, Silvia Tschuor; Meylan, Pascal; Bernasconi, Enos

doi:10.1016/j.ijid.2013.01.031

Cited by 83 publications

(73 citation statements)

References 21 publications

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“…Of the seventeen patients, only one was immunocompromised (6%). This finding is comparable to results from other studies –18% in Switzerland,[4] 12% in the United States,[5] and 10% in Israel. [6] The single patient with immunocompromised state had HIV infection.…”

Section: Discussionsupporting

confidence: 90%

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Varicella zoster virus infection of the central nervous system – 10 year experience from a tertiary hospital in South India

Carey

Chandiraseharan

Jasper

et al. 2017

Ann Indian Acad Neurol

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Introduction:Varicella zoster virus is an exclusively human neurotrophic virus. The primary infection with the virus causes varicella. The virus remains latent in nervous tissue and upon secondary activation causes a variety of syndromes involving the central nervous system (CNS) including meningoencephalitis and cerebellitis.Materials and Methods:In this study, we looked at the epidemiology, clinical and laboratory features, and outcomes of patients who were admitted with varicella zoster of the CNS from 2005 to 2014.Results:There were 17 patients. Fever was present in 13 patients, seizures in 9 patients and headache and vomiting in 4 patients each. A generalized varicella rash was present in 8 out of 17 patients. A single dermatomal herpes zoster was present in seven patients. Two patients had no rash. Varicella zoster polymerase chain reaction (PCR) in cerebrospinal fluid (CSF) was done in 5 patients of which 4 were positive and 1 was negative. Nine patients had diabetes with an average glycated hemoglobin of 8.6%. Total number of deaths was five.Conclusions:Patients with diabetes who develop varicella or herpes zoster may be at risk for CNS complications. The diagnosis of varicella encephalitis has to rest on a combination of clinical findings and CSF PCR, as neither the rash nor the PCR is sensitive enough to diagnose all the cases with varicella encephalitis.

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Section: Discussionsupporting

confidence: 90%

“…also reported that only 5 out of 11 patients (45%) had a vesicular rash in patients with varicella meningoencephalitis. [4] In another study, from California, only 11 out of 26 patients (42%) who tested positive for VZV PCR had a rash. [5] In a study from the UK, seven out of eight patients (88%) with CNS varicella infection had a rash.…”

Section: Discussionmentioning

confidence: 99%

Varicella zoster virus infection of the central nervous system – 10 year experience from a tertiary hospital in South India

Carey

Chandiraseharan

Jasper

et al. 2017

Ann Indian Acad Neurol

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“…In a previous retrospective analysis of central nervous system VZV reactivation, 71% of aseptic meningitis cases were noted in male patients9. In regards to the study of HZ prevalence, a Swedish analysis revealed a female predominance10, and a systematic review of European data by Pinchinat et al11 also reported higher incidence rates in female patients.…”

Section: Discussionmentioning

confidence: 98%

Risk Factors for Aseptic Meningitis in Herpes Zoster Patients

Kim¹,

Choi²,

Kim³

et al. 2017

Ann Dermatol

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BackgroundHerpes zoster (HZ) is caused by reactivation of latent varicella-zoster virus (VZV) infection. HZ-associated aseptic meningitis, a rare complication of HZ, can require hospitalization and a long treatment period.ObjectiveA retrospective study was performed to identify potential factors associated with HZ-associated aseptic meningitis development.MethodsWe included all outpatients and patients admitted in the neurology and dermatology departments of a single tertiary center, who were diagnosed with HZ for two years. Among 818 patients, 578 patients were eligible for analysis.ResultsThe demographics and potential risk factors were compared between the uncomplicated HZ group (n=554) and aseptic meningitis group (n=24). Among the potential factors, the dermatological distribution of skin rash and gender showed statistically significantly different between the two groups. Patients with craniocervical distribution of HZ accounted for 87.5% (n=21) of the aseptic meningitis group and 54.3% (n=301) of the uncomplicated HZ group (p=0.043). The aseptic meningitis group had more men (66.7%, n=16) than the uncomplicated HZ group (42.8%, n=237, p=0.033). Patients with craniocervical distribution had an odds ratio (OR) of 5.884 (p=0.001) for developing aseptic meningitis when compared with the other dermatome involvements. Additional logistic regression analysis resulted in a fading between gender difference (p=0.050) and craniocervical involvement having an OR of 5.667 for aseptic meningitis (p=0.006).ConclusionIn HZ patients, skin rash with craniocervical distribution and male gender were associated with a higher risk of aseptic meningitis.

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“…In certain conditions, VZV can reactivate and cause herpes zoster. There is a difference in onset time of primary VZV infection in different geographic regions (4). Generally, the infection time in people who have lived in temperate regions is earlier than those who have lived in tropical regions.…”

Section: Introductionmentioning

confidence: 99%

“…The primary VZV infection in humans results in chickenpox. Following the recovery from chickenpox, the VZV becomes dormant in the sensory ganglia-like dorsal root ganglia (3,4). In certain conditions, VZV can reactivate and cause herpes zoster.…”

Section: Introductionmentioning

confidence: 99%

Genotyping of clinical varicella-zoster virus isolates collected from Yunnan in Southwestern China

Zhu

2015

Biomedical Reports

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Abstract. Varicella-zoster virus (VZV) belongs to the α-herpesvirus family. Genetically, it is stable and is divided into several genotypes based upon the genetic variations. The genotypes of VZV are rarely studied in the Southwestern region of China. In the present study, the common genetic variations in the VZV genes were examined in 42 VZV isolates collected from the patients with herpes zoster in the Yunnan province (Southwestern China). The restriction fragment length polymorphism analysis of open reading frames (ORFs) 38, 54 and 62 in the VZV genes showed that all the collected VZV isolates were PstI, BglI and SmaI positive. The R5 variable-repeat region in these isolates was variable (R5A: 46.4%; R5B: 53.6%). The sequencing data of ORFs 1, 21, 22 and 54 indicated that 41 of the 42 collected VZV isolates could be grouped into genotype J or J1. Only one VZV isolate was identified as genotype A1 or M2. No new substitutions in the sequenced fragments were found in the collected VZV isolates. The results of the present study provided a preliminary genetic characterization of the VZV strains in the Yunnan province of Southwestern China.

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Infection of the central nervous system caused by varicella zoster virus reactivation: a retrospective case series study

Abstract: Screening of CSF for VZV by PCR is recommended for all patients with encephalitis and for those with viral meningitis of unclear origin in order to better target antiviral treatment.

Cited by 83 publications

References 21 publications

Varicella zoster virus infection of the central nervous system – 10 year experience from a tertiary hospital in South India

Varicella zoster virus infection of the central nervous system – 10 year experience from a tertiary hospital in South India

Risk Factors for Aseptic Meningitis in Herpes Zoster Patients

Genotyping of clinical varicella-zoster virus isolates collected from Yunnan in Southwestern China

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