A Rare Case of Varicella-Zoster Virus Meningitis With High Intracranial Pressure in an Immunocompetent Adult
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...
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| Veröffentlicht in: | Curēus (Palo Alto, CA) CA), 2024-01, Vol.16 (1), p.e52437 |
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| container_title | Curēus (Palo Alto, CA) |
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| creator | Al Harbi, Awad Saeedi, Jameelah Almowalad, Enas Alahmari, Razan Alzuabi, Hana A Almanea, Leenah AlAbdulhadi, AlAnoud |
| description | 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. |
| doi_str_mv | 10.7759/cureus.52437 |
| format | Article |
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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.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.52437</identifier><identifier>PMID: 38370997</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Antiviral drugs ; Bacterial infections ; Case reports ; Cerebrospinal fluid ; Chicken pox ; Cytomegalovirus ; E coli ; Glucose ; Headaches ; Herpes viruses ; Hospitals ; Immunocompetence ; Intracranial pressure ; Leukocytes ; Listeria ; Medicine ; Meningitis ; Ophthalmology ; Patients ; Polymerase chain reaction ; Proteins ; Streptococcus infections</subject><ispartof>Curēus (Palo Alto, CA), 2024-01, Vol.16 (1), p.e52437</ispartof><rights>Copyright © 2024, Al Harbi et al.</rights><rights>Copyright © 2024, Al Harbi et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c211t-b8833237bcd5990b5c7ddf5e086b8efc22ce59cb5c771a80aea81734e43cd0483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38370997$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Al Harbi, Awad</creatorcontrib><creatorcontrib>Saeedi, Jameelah</creatorcontrib><creatorcontrib>Almowalad, Enas</creatorcontrib><creatorcontrib>Alahmari, Razan</creatorcontrib><creatorcontrib>Alzuabi, Hana A</creatorcontrib><creatorcontrib>Almanea, Leenah</creatorcontrib><creatorcontrib>AlAbdulhadi, AlAnoud</creatorcontrib><title>A Rare Case of Varicella-Zoster Virus Meningitis With High Intracranial Pressure in an Immunocompetent Adult</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Varicella-zoster virus (VZV) is an alphaherpesvirus causing varicella (chickenpox) and herpes zoster. 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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.</description><subject>Antiviral drugs</subject><subject>Bacterial infections</subject><subject>Case reports</subject><subject>Cerebrospinal fluid</subject><subject>Chicken pox</subject><subject>Cytomegalovirus</subject><subject>E coli</subject><subject>Glucose</subject><subject>Headaches</subject><subject>Herpes viruses</subject><subject>Hospitals</subject><subject>Immunocompetence</subject><subject>Intracranial pressure</subject><subject>Leukocytes</subject><subject>Listeria</subject><subject>Medicine</subject><subject>Meningitis</subject><subject>Ophthalmology</subject><subject>Patients</subject><subject>Polymerase chain reaction</subject><subject>Proteins</subject><subject>Streptococcus infections</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpNkE1Lw0AQhhdRbKm9eZYFr6buR9LdHEtRW6goohW8hM1m0m5JNnU_Dv57W1vF07wMD-8MD0KXlIyEyPJbHR1EP8pYysUJ6jM6lomkMj39l3to6P2GEEKJYESQc9TjkguS56KPmgl-UQ7wVHnAXY2XyhkNTaOSj84HcHhpXPT4EayxKxOMx-8mrPHMrNZ4boNT2ilrVIOfHXi_-wYbi5XF87aNttNdu4UANuBJFZtwgc5q1XgYHucAvd3fvU5nyeLpYT6dLBLNKA1JKSXnjItSV1mekzLToqrqDIgclxJqzZiGLNf7vaBKEgVKUsFTSLmuSCr5AF0fereu-4zgQ7HporO7kwXLOU-ZZDt-gG4OlHad9w7qYutMq9xXQUmxt1sc7BY_dnf41bE0li1Uf_CvS_4N7953BQ</recordid><startdate>20240117</startdate><enddate>20240117</enddate><creator>Al Harbi, Awad</creator><creator>Saeedi, Jameelah</creator><creator>Almowalad, Enas</creator><creator>Alahmari, Razan</creator><creator>Alzuabi, Hana A</creator><creator>Almanea, Leenah</creator><creator>AlAbdulhadi, AlAnoud</creator><general>Cureus Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20240117</creationdate><title>A Rare Case of Varicella-Zoster Virus Meningitis With High Intracranial Pressure in an Immunocompetent Adult</title><author>Al Harbi, Awad ; 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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. 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| source | PubMed Central; PubMed Central Open Access |
| subjects | Antiviral drugs Bacterial infections Case reports Cerebrospinal fluid Chicken pox Cytomegalovirus E coli Glucose Headaches Herpes viruses Hospitals Immunocompetence Intracranial pressure Leukocytes Listeria Medicine Meningitis Ophthalmology Patients Polymerase chain reaction Proteins Streptococcus infections |
| title | A Rare Case of Varicella-Zoster Virus Meningitis With High Intracranial Pressure in an Immunocompetent Adult |
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