An An Unusual Presentation of Varicella Meningitis: A Case Report and Review of the Literature

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Matthew Patel
Rachel Bierbrier
Katina Tzanetos


Varicella Zoster Virus (VZV) primary infection causes chickenpox, often in young children, and is characterized by vesicular lesions on the face, limbs and trunk. In immunocompetent hosts, the infection is usually mild and self-limited. Following infection the virus remains dormant in the dorsal root ganglia but can reactivate, replicate and cause Herpes zoster (shingles), a painful vesicular eruption in a single dermatomal distribution.1, 2 Although Herpes zoster typically presents with this characteristic rash, there are reports of zoster sine herpete herpes zoster without the presence of a rash but with pain.1 Neurologic complications, including meningitis, encephalitis or myelitis can occur with acute infection or reactivation of VZV, but is uncommon in immunocompetent hosts, and even more rare without an exanthema.3 This report describes a case of reactivation VZV meningitis without any viral exanthema in a young healthy male.  

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