• BMJ case reports · Feb 2015

    Case Reports

    Varicella-zoster meningitis with a late-onset of skin eruption.

    • Anawin Sanguankeo, Sikarin Upala, Suthanya Sornprom, and Natanong Thamcharoen.
    • Bassett Medical Center, Columbia University College of Physicians and Surgeons, Cooperstown, New York, USA Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
    • BMJ Case Rep. 2015 Feb 17; 2015.

    AbstractViral meningitis caused by varicella-zoster virus (VZV) is an uncommon neurological complication of herpes zoster. It may occur before or after the onset of the vesicular rash along the dermatomal distribution, which is the classic presentation of herpes zoster. We describe a case of a 51-year-old immunocompetent Caucasian man who presented with neck and severe right-sided facial pain. Eight days later, he had photophobia and papular rash on his forehead. Cerebrospinal fluid (CSF) examination confirmed aseptic meningitis and CSF PCR detected the presence of VZV DNA. Neurological complications of VZV infection, such as aseptic meningitis, may be difficult to diagnose and can cause delay in treatment, especially in cases with late onset of dermatological manifestations of herpes zoster. Definite diagnosis requires evidence of acute VZV infection in blood or cerebrospinal fluid.2015 BMJ Publishing Group Ltd.

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