Varicella-zoster virus: an overlooked cause of aseptic meningitis

Jhaveri, Ravi; Sankar, Raman; Yazdani, Shahram; Cherry, James D.

doi:10.1097/00006454-200301000-00026

Cited by 32 publications

(23 citation statements)

References 18 publications

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“…Hypoglycorrhachia with VZV infection has been reported in zoster meningitis of immunocompetent adults (Echevarria et al, 1987; Moriuchi et al, 1997), even in the absence of rash (Mayo and Booss, 1989) and in children (Jhaveri et al, 2003; Leahy et al, 2008), as confirmed by PCR and serology. Hypoglycorrhachia has also been found in VZV meningoencephalitis after ophthalmic distribution zoster (Reimer and Beller, 1981; Norris et al, 1970) and in zoster polyneuritis with no rash (Mayo and Booss, 1989).…”

Section: Discussionmentioning

confidence: 80%

Varicella zoster virus meningitis with hypoglycorrhachia in the absence of rash in an immunocompetent woman

et al. 2009

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We report varicella-zoster virus (VZV) meningitis in a healthy adult woman with no antecedent rash and with hypoglycorrhachia. Cerebrospinal fluid (CSF) examination revealed the presence of VZV DNA, anti-VZV immunoglobulin G (IgG) antibody, and intrathecal production of anti-VZV IgG antibody.Keywords varicella zoster; meningitis; hypoglycorrhachia; PCR; immunocompetent Case reportA 26-year-old healthy Bhutanese woman developed increasing throbbing bitemporal headache with photophobia, severe nausea, and vomiting over 2 days. She had been afebrile and denied neck stiffness. There was no past history of headache, skin rash, recent insect bite, or contact with individuals with infections. She had chickenpox at age 5 years. She had emigrated from Bhutan 7 years earlier, but had not traveled abroad recently. Her sister had been treated for tuberculosis. She worked currently as a nanny; the children under her care were healthy and had received Varivax months earlier. On examination, the patient was afebrile and had no rash, nuchal rigidity, or abnormal neurological signs.On day 6 after becoming ill, white blood cell (WBC) count and routine blood chemistries, liver enzymes, erythrocyte sedimentation rate (ESR), anti-nuclear antibody, rapid plasma reagin, and human immunodeficiency virus testing were negative. Brain magnetic resonance imaging (MRI) revealed an ill-defined T2 hyperintensity in the right frontal lobe, extending from the cortical surface to the frontal horn of the lateral ventricle without mass effect, consistent with a hamartoma or cortical dysplasia. The cerebrospinal fluid (CSF) contained 331 WBCs, 99%

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Section: Discussionmentioning

confidence: 80%

Varicella zoster virus meningitis with hypoglycorrhachia in the absence of rash in an immunocompetent woman

et al. 2009

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“…4 Cases of neurologic complications associated with reactivated VZV but without rash (zoster sine herpete) in unvaccinated immunocompetent children have also been reported. 8,9 Detection of wild-type VZV, and the absence of varicella rash history, indicate this patient had unrecognized varicella, either previously or at the time of this fatal illness. We were unable to determine whether the patient's encephalitis was because of breakthrough infection or herpes zoster.…”

Section: Discussionmentioning

confidence: 90%

“…8 for detection of C. cayetanensis, pCr amplification was performed on the ssU-rrNA coding region of the genome (table, supplemental Digital Content 1, http://links.lww.com/iNf/B351). 9 A 2-step nested pCr protocol was used to amplify a 450 bp fragment of the its-1 rDNA locus of I. belli (table, supplemental Digital Content 1, http://links.lww.com/iNf/B351). 10 positive and negative controls were used for each pCr batch.…”

Section: Parasitologic Methodsmentioning

confidence: 99%

Fatal Wild-Type Varicella-Zoster Virus Encephalitis Without A Rash in A Vaccinated Child

Ibraheem¹,

Marin

Leung

et al. 2013

Pediatric Infectious Disease Journal

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Encephalitis associated with varicella-zoster virus, rare among children in the varicella vaccine era, has generally been associated with a rash. We report fatal wild-type varicella-zoster virus encephalitis without a rash in a child who had received 1 dose of varicella vaccine. Varicella-zoster virus encephalitis should be considered in the differential diagnosis for children presenting with acute neurologic symptoms, even vaccine recipients.

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“…Meningitis findings may start before the eruption occurs, may be simultaneous with the eruption or may develop in days after the eruption starts (12). Rarely, aseptic meningitis occurs without eruption (13,14). No relation could be found between the area of eruption and development of aseptic meningitis (3).…”

Section: Discussionmentioning

confidence: 99%

Zona zoster enfeksiyonu sırasında gelişen aseptik menenjit

...

2012

Tpa

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Sum maryZona zoster is generally a benign disease in immunocompetent children. In immunocompromised children, there is a risk of dissemination. Zona zoster rarely causes some neurological complications such as myelitis, aseptic meningitis, encephalitis and ventriculitis in both immunocompetent and immunocompromised children. A 17-year-old girl who had bone marrow transplantation for thalasemia major was admitted to our hospital with fever, itchy rash on the right chest and axillary region and diagnosed as zona zoster. She had severe headache and vomiting on follow-up. Lumbar puncture was performed, because of positive neck stiffness and meningeal irritation signs and pleocytosis and protein elevation were detected in the cerebrospinal fluid (CSF). The diagnosis of aseptic meningitis due to zona zoster was confirmed by VZV-PCR in the CSF . She cured without sequelea after the administration of acyclovir treatment for 10 days. If symptoms such as headache and vomiting develop in immunocompromised children with zona zoster, neurological complications including aseptic meningitis should be remembered. (Turk Arch Ped 2012; 47: 142-5)

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Varicella-zoster virus: an overlooked cause of aseptic meningitis

Cited by 32 publications

References 18 publications

Varicella zoster virus meningitis with hypoglycorrhachia in the absence of rash in an immunocompetent woman

Varicella zoster virus meningitis with hypoglycorrhachia in the absence of rash in an immunocompetent woman

Fatal Wild-Type Varicella-Zoster Virus Encephalitis Without A Rash in A Vaccinated Child

Zona zoster enfeksiyonu sırasında gelişen aseptik menenjit

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