Atypical varicella-zoster virus reactivation: a case report

Abstract

Varicella-zoster virus (VZV) commonly causes benign skin manifestations in children; it then establishes a latent infection and may reactivate, causing herpes zoster. The most common zoster complication is postherpetic neuralgia, but complications can also occur without a rash. VZV infection may cause neurological manifestations and even vasculopathy may occur, in both primary and reactivated VZV infection. Thrombotic complications are mainly described in children, while a few case reports have described cerebral venous sinus thrombosis (CVST), deep-vein thrombosis of the lower limbs and pulmonary embolism in adults. In this article we report the case of a young woman who developed systemic thromboembolic sequelae due to a hypercoagulable state following VZV reactivation. She had deep venous lower-limb thrombosis extended to the inferior vena cava (IVC), massive pulmonary embolism and CVST. Moreover, VZV reactivation caused an acute hepatitis and clinical manifestations suggesting viral encephalitis.

Deep Venous Thrombosis - A Rare Complication of Herpes Zoster

“…Thrombotic complications secondary to varicella infection were mainly described in children, however few case reports were documented in adults. Examples of them are cortical venous thrombosis, pulmonary thromboembolism, tibial artery thrombosis, Deep venous thrombosis of legs (Mehkri et al, 2022) (Salvotti et al, 2023) (Sahra et al, 2021) (Peyton et al, 1998) (Maity et al, 2014). The underlying pathology for the increased risk of thrombosis was due to endothelial cell damage and procoagulant state.…”

Varicella-Zoster Virus Reactivation and Increased Vascular Risk in People Living with HIV: Data from a Retrospective Cohort Study

“…Thrombotic complications following HZ have been described, especially in children, while a few case reports have described cerebral venous sinus thrombosis, deepvenous thrombosis of the lower limbs, and pulmonary embolism in adults [20][21][22][23][24][25].…”