Focal encephalitis following varicella-zoster virus reactivation without rash in a healthy immunized young adult

Geoffrey Halling; Caterina Giannini; Jeffrey W Britton; Ricky W Lee; Robert E Watson Jr; Christine L Terrell; Ian F Parney; Erin M Buckingham; John E Carpenter; Charles Grose

doi:10.1093/infdis/jiu137

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Focal encephalitis following varicella-zoster virus reactivation without rash in a healthy immunized young adult

Journal article

Open access

Peer reviewed

Focal encephalitis following varicella-zoster virus reactivation without rash in a healthy immunized young adult

Geoffrey Halling, Caterina Giannini, Jeffrey W Britton, Ricky W Lee, Robert E Watson Jr, Christine L Terrell, Ian F Parney, Erin M Buckingham, John E Carpenter and Charles Grose

The Journal of infectious diseases, Vol.210(5), pp.713-716

09/01/2014

DOI: 10.1093/infdis/jiu137

PMCID: PMC4202304

PMID: 24604820

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Abstract

Herein we describe an episode of focal varicella-zoster virus (VZV) encephalitis in a healthy young man with neither rash nor radicular pain. The symptoms began with headaches and seizures, after which magnetic resonance imaging detected a single hyperintense lesion in the left temporal lobe. Because of the provisional diagnosis of a brain tumor, the lesion was excised and submitted for pathological examination. No tumor was found. But the tissue immunostained positively for VZV antigens, and wild-type VZV sequences were detected. In short, this case represents VZV reactivation, most likely in the trigeminal ganglion, in the absence of clinical herpes zoster.

Immunohistochemistry

Radiography

Magnetic Resonance Imaging

Encephalitis, Varicella Zoster - pathology

Brain - diagnostic imaging

Humans

DNA, Viral - isolation & purification

Herpesvirus 3, Human - immunology

Male

Seizures - diagnosis

Herpesvirus 3, Human - isolation & purification

Young Adult

Pain - physiopathology

Encephalitis, Varicella Zoster - physiopathology

Exanthema - pathology

Seizures - etiology

Brain - pathology

DNA, Viral - genetics

Virus Activation

Encephalitis, Varicella Zoster - diagnosis

Details

Title: Subtitle: Focal encephalitis following varicella-zoster virus reactivation without rash in a healthy immunized young adult
Creators: Geoffrey Halling - Department of Laboratory Medicine and Pathology
Caterina Giannini - Department of Laboratory Medicine and Pathology
Jeffrey W Britton - Department of Neurology
Ricky W Lee - Department of Neurology
Robert E Watson Jr - Department of Radiology
Christine L Terrell - Department of Internal Medicine
Ian F Parney - Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota
Erin M Buckingham - Division of Infectious Diseases/Virology, University of Iowa Children's Hospital, Iowa City
John E Carpenter - Division of Infectious Diseases/Virology, University of Iowa Children's Hospital, Iowa City
Charles Grose - Division of Infectious Diseases/Virology, University of Iowa Children's Hospital, Iowa City
Resource Type: Journal article
Publication Details: The Journal of infectious diseases, Vol.210(5), pp.713-716
DOI: 10.1093/infdis/jiu137
PMID: 24604820
PMCID: PMC4202304
ISSN: 0022-1899
eISSN: 1537-6613
Grant note: R01 AI089716 / NIAID NIH HHS AI 89716 / NIAID NIH HHS
Language: English
Date published: 09/01/2014
Academic Unit: Stead Family Department of Pediatrics; Infectious Disease (Pediatrics)
Record Identifier: 9984093233302771

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