Presentation
The exact proportion of patients with VZV primary and reactivation infection who present with lesions prior to or concomitant to its involvement in the CNS is unknown. [pubmed.ncbi.nlm.nih.gov]
CASE REPORT A previously healthy 7-year-old boy presented with a 4-day history of right arm pain; a 2-day history of right arm rash; and a 1-day history of fever, headache, photophobia, and vomiting. [journals.lww.com]
Diseases, TexasA &M Health Science Center College of Medicine, Temple, Texas, USA Correspondence to Dr Raghesh Varot Kangath, drraghesh.vk{at}gmail.com Summary A 30-year-old Caucasian woman, without significant medical history or immunosuppression, presented [casereports.bmj.com]
Case presentation An 11-year-old Asian girl presented with headache and skin rash on the left side of her chest that had begun 3 days earlier. [jmedicalcasereports.biomedcentral.com]
Record: found Abstract: found Article: not found Varicella-zoster virus: atypical presentations and unusual complications. [scienceopen.com]
Entire Body System
- Fever
His symptoms were headache, fever and a rash with vesicles in the dermatome that corresponds to T8. He was diagnosed with meningitis by the varicella-zoster virus. [scienceopen.com]
CASE REPORT A previously healthy 7-year-old boy presented with a 4-day history of right arm pain; a 2-day history of right arm rash; and a 1-day history of fever, headache, photophobia, and vomiting. [journals.lww.com]
Skin
- Ulcer
One month later, he developed a central epithelial defect with a rolled margin, typical of a neurotrophic ulcer. [epistemonikos.org]
Neurologic
- Altered Mental Status
There was no nuchal rigidity, and there was no evidence of neurologic deficit or altered mental status. Laboratory studies revealed a peripheral white blood cell count of 7000 cells/mm with 77% neutrophils, 13% lymphocytes, and 10% monocytes. [journals.lww.com]
Treatment
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. [casereports.bmj.com]
Treatment with a therapeutic contact lens and a combination of topical recombinant human epithelial growth factor and ofloxacin ointment was initiated. [epistemonikos.org]
All patients received antiviral treatment. Therapy duration was from 10 up to 21 days. The clinical course was positive in most patients and the mean hospitalization time was 15 days (range 5-60 days). No mortality was observed. [pubmed.ncbi.nlm.nih.gov]
Varicella-zoster virus infections of the central nervous system – Prognosis, diagnostics and treatment. Journal of Infection. 2015;71(3):281-293. Zaragoza-Velasco K, Martínez-Gudiño M de L, Robles-Ramírez F. [revistas.juanncorpas.edu.co]
[…] at 10 to 15 mg/kg every 8 hours for 10 to 14 days for VZV encephalitis on the basis of case reports and small series.10 While awaiting the results of immunodeficiency evaluation and VZV virus genotyping, we opted for a 21-day course that mirrors the treatment [journals.lww.com]
Prognosis
Varicella-zoster virus infections of the central nervous system – Prognosis, diagnostics and treatment. Journal of Infection. 2015;71(3):281-293. Zaragoza-Velasco K, Martínez-Gudiño M de L, Robles-Ramírez F. [revistas.juanncorpas.edu.co]
The clinical prognosis of VZV meningitis seems to be appreciable, considering our patient’s case and other case reports [5,6,7,8,9,10]. No neurological sequelae have been reported. [jmedicalcasereports.biomedcentral.com]
Etiology
Varicella-zoster virus (VZV) is the etiologic agent of varicella (primary infection) and herpes zoster (reactivation of latent infection). [scienceopen.com]
The etiologic agent in our case, as in other reported cases, was established by the VZV genotyping at the Centers for Disease Control and Prevention.12 Given the routine childhood immunization with varicella vaccine in the United States, we speculate [journals.lww.com]
Epidemiology
DISCUSSION The implementation of routine varicella vaccination has dramatically shifted the clinical epidemiology of primary VZV infection for children in the United States. [journals.lww.com]
Advances understanding of the pathogenesis and epidemiology of herpes zoster. J Clin Virol. 2010;48 Suppl 1:S2–7. Article Google Scholar Latif R, Shope TC. Herpes zoster in normal and immunocompromised children. Am J Dis Child. 1983;137:801–2. [jmedicalcasereports.biomedcentral.com]
Prevention
VZV from both sites was identified as vaccine strain according to genotyping performed at the National VZV Laboratory of the Centers for Disease Control and Prevention in Atlanta, GA. [journals.lww.com]