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Lewandowski D, Toczylowski K, Kowalska M, Krasnodębska M, Krupienko I, Nartowicz K, Sulik M, Sulik A. Varicella-Zoster Disease of the Central Nervous System in Immunocompetent Children: Case Series and a Scoping Review. Vaccines (Basel) 2024; 12:1086. [PMID: 39340116 PMCID: PMC11435507 DOI: 10.3390/vaccines12091086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Revised: 09/10/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Varicella-Zoster Virus (VZV) is characterized by its ability to enter a dormant state within the body. When the wild or vaccine virus reactivates, it can lead to herpes zoster (HZ), which infrequently manifests as a neuroinfection. OBJECTIVES The aim of the study was to analyze the clinical manifestations and outcomes associated with VZV reactivation in the CNS in immunocompetent children. METHODS We searched medical databases for case reports using the keywords "zoster", "meningitis", "encephalitis", and "immunocompetent". The inclusion criteria were age below 18 years, any gender, race, and ethnicity, no features or history of immunodeficiency, and confirmation of VZV reactivation through the detection of VZV DNA in the CSF. Patients were categorized into two groups: children experiencing the reactivation of the wild virus and children with the vaccine strain virus. RESULTS The cohort included six children hospitalized in our hospital and 49 children reported in the literature. In 37 (67%), a wild-type virus was detected, while in 18 (33%), an infection was caused by the vaccine strain. There were no differences in the clinical presentation between the two groups. A typical rash was observed in 32 (58%) children. Approximately 41 of the 55 children (75%) received antiviral treatment. Four patients experienced complications. CONCLUSIONS Neither a history of VZV immunization nor the absence of a skin rash can definitively exclude VZV meningitis. It is important to note that any seemingly healthy child, regardless of recognized risk factors, could develop HZ meningitis.
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Affiliation(s)
- Dawid Lewandowski
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
| | - Kacper Toczylowski
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
| | - Malgorzata Kowalska
- Department of Pediatric Surgery and Neurology, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
| | - Milena Krasnodębska
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
| | - Iryna Krupienko
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
| | - Karolina Nartowicz
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
| | - Magdalena Sulik
- Department of Pediatrics, Endocrinology, Diabetology with Cardiology Divisions, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
| | - Artur Sulik
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
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Al Harbi A, Saeedi J, Almowalad E, Alahmari R, Alzuabi HA, Almanea L, AlAbdulhadi A. A Rare Case of Varicella-Zoster Virus Meningitis With High Intracranial Pressure in an Immunocompetent Adult. Cureus 2024; 16:e52437. [PMID: 38370997 PMCID: PMC10870954 DOI: 10.7759/cureus.52437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Varicella-zoster virus (VZV) is an alphaherpesvirus causing varicella (chickenpox) and herpes zoster. While varicella typically presents with a vesicular rash, latent VZV may reactivate within the sensory ganglia causing shingles, characterized by painful vesicular rash, which may lead to neurologic complications such as aseptic meningitis. This case explores an atypical presentation in an immunocompetent young man with VZV meningitis lacking the characteristic skin rash but featuring elevated intracranial pressure. A literature review revealed rare instances of VZV-related neurologic disease without typical skin manifestations, suggesting the virus's potential to affect the central nervous system directly. Treatment with intravenous acyclovir is recommended, with ganciclovir as an alternative treatment option. This case emphasizes the importance of considering VZV meningitis in the differential diagnosis of patients presenting with viral meningitis symptoms, with or without dermatomal rash or immunocompromised conditions.
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Affiliation(s)
- Awad Al Harbi
- Neurosciences, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Jameelah Saeedi
- Neurology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, SAU
| | - Enas Almowalad
- Neurology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, SAU
| | - Razan Alahmari
- College of Medicine, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Hana A Alzuabi
- Medicine and Surgery, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Leenah Almanea
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
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3
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Lorenzini G, Cucchiara F, Pennati P. An unusual case of facial palsy in an immunocompetent adult woman. Intern Emerg Med 2023; 18:2333-2337. [PMID: 37148408 DOI: 10.1007/s11739-023-03295-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Gianni Lorenzini
- Department of Emergency Medicine, Bassa Val Di Cecina Hospital, Via Montanara 52B, 57023, Cecina, LI, Italy
| | - Federico Cucchiara
- Department of Emergency Medicine, Bassa Val Di Cecina Hospital, Via Montanara 52B, 57023, Cecina, LI, Italy
| | - Paolo Pennati
- Department of Emergency Medicine, Bassa Val Di Cecina Hospital, Via Montanara 52B, 57023, Cecina, LI, Italy.
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Xie S, Yang X, Xia H, Lai J, Liu Q, Lu Z, He D, Liu X. Clinical features of varicella-zoster virus caused neurological diseases detected by metagenomic next-generation sequencing. Open Med (Wars) 2023; 18:20230744. [PMID: 37465353 PMCID: PMC10350883 DOI: 10.1515/med-2023-0744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 07/20/2023] Open
Abstract
Clinical presentation of central nervous system (CNS) infections caused by varicella-zoster virus (VZV) is highly sophisticated, making identification challenging. We retrospectively reported 18 cases of VZV neurologic disease confirmed by metagenomic next-generation sequencing (mNGS). The detection rate of mNGS was higher than that of PCR assay (100 vs 66.7%, p < 0.05) and serum IgM antibody (100 vs 68.8%, p < 0.05) measurement. Of the 18 cases, five patients were diagnosed with acute meningitis, three with acute meningitis combined with facial neuritis, three with acute meningitis combined with polycranial neuritis, and the remaining seven with various clinical diagnoses. Typical clinical symptoms included headache (15), fever (9), and rash (11). Cranial or spinal MRI showed abnormalities in 12 patients, and 17 patients had obvious neurological symptoms. The predominant genotype of VZV in this study was genotype J (100%, 10/10). All patients were treated with acyclovir/penciclovir and dexamethasone, 16 recovered and 2 died. Our study highlights the good performance of mNGS in diagnosing CNS infection caused by VZV. It could provide additional diagnostic evidence in patients with diverse clinical spectrum and variable manifestations.
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Affiliation(s)
- Shuhua Xie
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Xuying Yang
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, 100000, China
| | - Han Xia
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, 100000, China
| | - Jinxing Lai
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Qing Liu
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Zhijuan Lu
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Dehai He
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Xianghong Liu
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
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5
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A Typical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult. Case Rep Infect Dis 2022; 2022:5626670. [DOI: 10.1155/2022/5626670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction. Aseptic meningitis can occur from different types of infections of which viral etiologies are the most common. Varicella zoster virus (VZV) nowadays is considered a familiar entity of aseptic meningitis. However, it is usually reported in immunocompromised patients. For cases of VZV meningitis that are observed, a rash has been noted before the onset of meningitis or sometimes after it. Clinical Case. We present an uncommon case of VZV meningitis in an 18-year-old immunocompetent male who did not have a rash on presentation and did not develop one during his course either. Cerebrospinal fluid showed lymphocyte-predominant leukocytosis and elevated protein with normal glucose suggestive of aseptic meningitis. Cerebrospinal fluid polymerase chain reaction (CSF PCR) was positive for VZV; cerebrospinal fluid cultures and blood cultures were negative. The patient had complete resolution of symptoms with no complications on intravenous acyclovir therapy and was discharged home on oral valacyclovir therapy. Conclusion. It is important to consider varicella zoster virus as an etiology of aseptic meningitis as clinical presentation can be without a vesicular rash and in immunocompetent patients.
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Ali Y, Habib MB, Safan A, Sawaf B, Elzouki A. Varicella Zoster meningitis as a mimicker of pseudotumor cerebri in an immunocompetent patient: A case report and literature review. Qatar Med J 2022; 2022:21. [PMID: 36340264 PMCID: PMC9631001 DOI: 10.5339/qmj.2022.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 03/27/2022] [Indexed: 09/07/2024] Open
Abstract
Varicella-zoster (VZ) meningitis is uncommon in patients with immunocompetence and usually presents with typical rash and fever. However, VZ meningitis can rarely present with symptoms of intracranial hypertension without the classic manifestations. Herein, we describe a 17-year-old female teen who presented with intractable headache and vomiting and diagnosed with VZ meningitis. Her symptoms remarkably improved after a lumbar puncture and acyclovir therapy.
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Affiliation(s)
- Yousra Ali
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Mhd Baraa Habib
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abeer Safan
- Neurology Department, Hamad Medical Corporation, Doha, Qatar
| | - Bisher Sawaf
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar E-mail:
| | - Abdelnaser Elzouki
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar E-mail:
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7
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Acute severe headache: Association of herpes zoster meningitis and sinus vein thrombosis. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.978248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Multicenter Evaluation of the Simplexa VZV Direct Assay for Detection of Varicella-Zoster Virus in Cerebrospinal Fluid and Lesion-Swab Specimens. J Clin Microbiol 2022; 60:e0235521. [PMID: 35285727 DOI: 10.1128/jcm.02355-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Varicella-zoster virus (VZV) is the etiologic agent of varicella (chickenpox) and herpes zoster (shingles) infections commonly involving skin, mucous membranes, and less frequently the central nervous system. Traditional methods for the laboratory diagnosis of these infections are time-consuming, labor-intensive, and often insensitive. As such, these tests are being replaced by more sensitive and rapid molecular methods. This study evaluated the performance of two different molecular assays, the Simplexa VZV Direct and Simplexa VZV Swab Direct, to detect VZV DNA in cerebrospinal fluid (CSF) and lesion-swab specimens, respectively. The Simplexa VZV Direct and Simplexa VZV Swab Direct assays were compared against individual composite reference methods that varied depending on the sample cohort examined. A total of 883 CSF and 452 cutaneous and mucocutaneous prospective, retrospective, and contrived specimens were evaluated in this multicenter study. The results of this study showed that the Simplexa assays demonstrated near perfect agreement (k = 0.98) compared to the composite reference methods for the detection of VZV in CSF and lesion swab specimens. A further comparison between the standard of care molecular assays employed at the site of specimen collection and the Simplexa assays demonstrated excellent agreement (k = 1.0). The Simplexa assays offer rapid and reliable alternatives for the detection of VZV in certain clinical specimens without the need for nucleic acid extraction.
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Sahra S, Jahangir A, Glaser A, Mobarakai N, Jahangir A. Case report: aseptic meningitis secondary to varicella-zoster virus (VZV) without an exanthem post MMR vaccination. BMC Infect Dis 2021; 21:746. [PMID: 34344345 PMCID: PMC8330204 DOI: 10.1186/s12879-021-06453-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 07/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Varicella-zoster virus (VZV) is a known cause of aseptic meningitis, with a predisposition for an immunocompromised population. A dermatomal rash usually accompanies aseptic meningitis secondary to VZV. CASE PRESENTATION We report the case of a 31-year-old male with a history of chickenpox in childhood and recent shingles who presented with severe frontal headaches secondary to VZV meningitis. The patient had also recently received the measles-mumps-rubella (MMR) vaccine. He recovered without any neurological sequala. CONCLUSION This case report describes an immunocompetent patient with recent MMR vaccination who developed aseptic meningitis secondary to VZV without any dermatomal involvement (Zoster Sine Herpete).
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Affiliation(s)
- Syeda Sahra
- Department of Internal Medicine, Hofstra School of Medicine, Staten Island University Hospital, 475-Seaview Avenue, Staten Island, NY, 10305, USA.
| | - Abdullah Jahangir
- Department of Internal Medicine, Hofstra School of Medicine, Staten Island University Hospital, 475-Seaview Avenue, Staten Island, NY, 10305, USA
| | - Allison Glaser
- Department of Internal Medicine, Hofstra School of Medicine, Staten Island University Hospital, 475-Seaview Avenue, Staten Island, NY, 10305, USA
| | - Neville Mobarakai
- Department of Internal Medicine, Hofstra School of Medicine, Staten Island University Hospital, 475-Seaview Avenue, Staten Island, NY, 10305, USA
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10
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Amaral V, Shi JZ, Tsang AMC, Chiu SSS. Primary varicella zoster infection compared to varicella vaccine reactivation associated meningitis in immunocompetent children. J Paediatr Child Health 2021; 57:19-25. [PMID: 33295075 DOI: 10.1111/jpc.15303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/30/2020] [Accepted: 11/19/2020] [Indexed: 12/24/2022]
Abstract
We diagnosed varicella zoster virus (VZV) meningitis in a healthy adolescent boy who presented without a rash or fever. We aim to compare VZV reactivation meningitis in children after primary VZV infection and VZV vaccination. We reviewed the literature up until June 2020 using Pubmed/MEDLINE and EMBASE databases using 'varicella zoster', 'meningitis' and 'children' as keywords. Only English articles were included. Twenty-five cases were included in this review. Children who had VZV reactivation meningitis after vaccination were younger (7 ± 3.4 years vs. 11.9 ± 3.6 years, P = 0.0038), had a shorter interval between first exposure to reactivation (5.6 ± 2.9 years vs. 8.8 ± 3.2 years, P = 0.018) and more likely to have a rash (100% vs. 55%, P = 0.04). VZV reactivation meningitis occurs after both primary VZV infection and VZV vaccination. The absence of exanthem, fever or meningism does not rule out VZV meningitis.
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Affiliation(s)
- Vanessa Amaral
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Julia Zhuo Shi
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Anita Man-Ching Tsang
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Susan Shui-Seng Chiu
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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11
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Varicella Zoster Virus Meningoencephalitis With an Atypical Presentation of Chest Pain, Impaired Memory, and Seizure. J Emerg Med 2020; 59:e175-e178. [PMID: 32972790 DOI: 10.1016/j.jemermed.2020.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 06/22/2020] [Accepted: 07/11/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Neurologic complications of varicella zoster virus (VZV) reactivation can be associated with considerable mortality and morbidity. Aseptic meningitis associated with VZV infection is rare, occurring in 0.5% of immunocompetent individuals. One third of VZV-related neurologic disease occurs without the classic herpes zoster exanthema, making early recognition more difficult. CASE REPORT A 60-year-old man presented to the emergency department with chest pain and impaired memory that he attributed to a transient ischemic attack as suggested by an urgent care facility 1 day earlier. He suffered a seizure while in the emergency department and was admitted to the intensive care unit. A computed tomography scan of his head and a magnetic resonance imaging scan were both negative for acute findings. An abnormal electroencephalogram consistent with an encephalopathy together with his new-onset seizure triggered a lumbar puncture that was positive for VZV. He was placed on acyclovir and was discharged from the hospital 5 days after admission. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The typical presentation of a VZV central nervous system infection occurs with a sudden onset of fever, headache, nuchal rigidity, and focal neurologic signs. Our patient's recent impaired memory and subsequent seizure were likely manifestations of the developing VZV meningoencephalitis, while his chest pain may have correlated with subsequent development of a vesicular rash. Seizures are encountered in 11% of patients with VZV central nervous system infection, and VZV has recently been associated with cerebral vasculopathy. Awareness of alternative presentations for herpes zoster and meningitis is important in cases without classic symptoms to enable diagnosis and prevent delays in treatment.
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Varicella Zoster Reactivation Causing Aseptic Meningitis in Healthy Adolescents: A Case Series And Review Of The Literature. Pediatr Infect Dis J 2020; 39:e278-e282. [PMID: 32467453 DOI: 10.1097/inf.0000000000002759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We describe 3 cases of adolescent varicella-zoster virus reactivation, complicated by aseptic meningitis, presenting to our institution in a 3-year period. These cases highlight varicella-zoster virus reactivation as an important cause of aseptic meningitis in the differential diagnosis of healthy adolescents, even in the absence of a characteristic exanthem. Evidence-based management recommendations are needed.
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13
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Gnoni M, Zaheer K, Vasser MM, Singh M, Ajmeri A, Harter SR, Mughees Rana A, Aguilar R. Varicella Zoster aseptic meningitis: Report of an atypical case in an immunocompetent patient treated with oral valacyclovir. IDCases 2018; 13:e00446. [PMID: 30167375 PMCID: PMC6115539 DOI: 10.1016/j.idcr.2018.e00446] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 08/21/2018] [Accepted: 08/23/2018] [Indexed: 11/16/2022] Open
Abstract
Varicella Zoster when described has the typical presentation of a dermatomal distribution of a rash and can further lead to CNS complications. This can be treated accordingly with the proper protocol, but if the presentation is atypical and the protocol is challenged or changed per specific patient outcomes, new developments can occur. Here we present a case of a 29-year-old Caucasian female that presented to the emergency department with headache, photophobia, and chills for 5 days. She was previously healthy and immunocompetent; CSF PCR analysis revealed a VZV infection causing acute aseptic meningitis with no shingles rash eruption on physical examination. The patient was not willing to stay hospitalized for the duration of the treatment. This gave us an opportunity to treat her with an oral, rather than IV, antiviral. The patient was successfully treated with oral valacyclovir 2 g Q6H after only receiving two days of IV acyclovir. To the best of our knowledge, this is the first reported case of a patient with VZV-associated meningitis successfully treated with oral valacyclovir.
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Affiliation(s)
- Martin Gnoni
- Our Lady of Bellefonte Hospital, 1000 St Christopher Dr, Ashland, KY 41101, United States
| | - Kamran Zaheer
- Our Lady of Bellefonte Hospital, 1000 St Christopher Dr, Ashland, KY 41101, United States
| | - Melinda M Vasser
- Our Lady of Bellefonte Hospital, 1000 St Christopher Dr, Ashland, KY 41101, United States
| | - Monider Singh
- Marshall University, MU Internal Medicine Residency Program, 1249 15th Street, Huntington, WV 25701, United States
| | - Aman Ajmeri
- Marshall University, MU Internal Medicine Residency Program, 1249 15th Street, Huntington, WV 25701, United States
| | - Stephanie R Harter
- Marshall University, MU Internal Medicine Residency Program, 1249 15th Street, Huntington, WV 25701, United States
| | - Abdul Mughees Rana
- Marshall University, MU Internal Medicine Residency Program, 1249 15th Street, Huntington, WV 25701, United States
| | - Rodrigo Aguilar
- Marshall University, MU Internal Medicine Residency Program, 1249 15th Street, Huntington, WV 25701, United States
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14
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Suri V, Mendiratta L, Chatterjee S, Sardana R, Butta H. Unusual Presentation of Varicella zoster Virus Meningitis - Role of Molecular Rapid Diagnostics in Diagnosis and Antimicrobial Stewardship. Ann Indian Acad Neurol 2018; 21:168-169. [PMID: 30122848 PMCID: PMC6073969 DOI: 10.4103/aian.aian_438_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Vinit Suri
- Department of Neurosciences, Indraprastha Apollo Hospitals, New Delhi, India
| | - Leena Mendiratta
- Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Suranjit Chatterjee
- Department of Internal Medicine, Indraprastha Apollo Hospitals, New Delhi, India
| | - Raman Sardana
- Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi, India
| | - Hena Butta
- Department of Microbiology, Indraprastha Apollo Hospitals, New Delhi, India
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15
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Al-Turab M, Chehadeh W. Varicella infection in the Middle East: Prevalence, complications, and vaccination. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:19. [PMID: 29887897 PMCID: PMC5961286 DOI: 10.4103/jrms.jrms_979_17] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/20/2017] [Accepted: 01/22/2018] [Indexed: 02/01/2023]
Abstract
Varicella (chickenpox) is the primary infection of varicella-zoster virus (VZV), it is a mild self-limiting infection, but it is also highly contagious and can cause severe complications among high-risk group of individuals. It is usually a childhood infection providing lifelong immunity, but adults without varicella history are also susceptible to infection. High-risk group of individuals is more likely to develop serious complications. Varicella vaccine was introduced to protect this group of individuals and to prevent epidemic spread of VZV infection in a community. Thus, it was added to the recommended vaccination schedules for children in most developed countries. This review aimed to outline varicella status, seroprevalence, complications, and vaccination in the Middle East region. Based on our findings, children were the most affected age group, but there are also adult cases due to high number of expatriates, especially in Gulf Cooperation Council countries. Central nervous system involvements and skin diseases followed by varicella pneumonia were the most varicella-associated complications. Varicella vaccine was introduced in most Middle East countries, either mandatory by the Ministries of Health or optional in the private clinics. Few numbers of studies have reported an obvious reduction in varicella prevalence, hospitalizations, and deaths in the Middle East following varicella vaccination. A basic database about varicella infection before the initiation and implementation of a vaccination policy is essential to determine the target group of individuals. As far as our knowledge, this is the first review about varicella infection in the Middle East.
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Affiliation(s)
- Mariam Al-Turab
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
| | - Wassim Chehadeh
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait
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