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Herpes zoster as a cause of viral meningitis in immunocompetent patients
Journal article   Open access   Peer reviewed

Herpes zoster as a cause of viral meningitis in immunocompetent patients

Raghesh Varot Kangath, Tracey Einem Lindeman and Karen Brust
BMJ case reports, Vol.2013(jan09 1), pp.bcr2012007575-bcr2012007575
2013
DOI: 10.1136/bcr-2012-007575
PMCID: PMC3604307
PMID: 23307457
url
https://europepmc.org/articles/pmc3604307View
Published (Version of record) Open Access

Abstract

A 30-year-old Caucasian woman, without significant medical history or immunosuppression, presented with a 7-day history of severe headache and neck pain. The patient was presumed to have tension headache versus migraine, but was admitted because her symptoms did not resolve. A lumbar puncture was performed showing lymphocytic pleocytosis suggestive of aseptic meningitis and the patient was started on broad-spectrum antibiotics and acyclovir. After admission, a rash was discovered on her left lumbar region with vesicles on top of an erythematous base. Varicella PCR was conducted on the patient's cerebrospinal fluid which was positive. Upon further history, patient was found to have previous varicella infection as a child, but no prior episodes of dermatomal zoster. Therefore, this patient was found to have aseptic meningitis and cutaneous manifestation of disseminated varicella-zoster despite immunocompetence. Antibacterial treatment was discontinued and she was continued on acyclovir for 7 days with transition to valacyclovir for 2 additional weeks with good treatment response and symptom resolution.

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