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Table 1 Characteristics of an immunocompetent adolescent with herpes zoster and aseptic meningitis due to VZV reactivation

From: A case of meningitis due to varicella zoster virus reactivation in an immunocompetent child

Characteristics Data
Demographics  
Age 14 years
Gender Male
Previous history  
Age at time of developing varicella 3 years
Clinical problems Recurrent respiratory tract infections in the first three years of life
Clinical presentation upon admission  
Axillary temperature 37.8°C
Skin lesions Dorsal herpes zoster (C8)
Neurological symptoms and signs Headache, slowness, drowsiness, unable to tolerate bright light, vomiting, stiff neck, exaggerated deep tendon reflexes, positive Brudzinski’s and Kernig’s signs
Diagnostic examinations upon admission  
White blood count 7,280/μL
Lymphocytes 31.7%
C-reactive protein 0.10 mg/dL
CSF examination Protein 95 mg/dL, glucose 48 mg/dL, 1,400 lymphocytes/μL, PCR positive for VZV DNA 1,250 cp/mL, PCR negative for herpes simplex virus 1 and 2, enterovirus, cytomegalovirus, Epstein Barr virus, JC virus
Immunological screening HIV negative, normal lymphocyte subpopulation counts, normal serum immunoglobulin and complement levels, vaccine responsiveness and lymphocytes stimulation tests
Electroencephalography Normal
CT and MR Normal
Antiviral therapy  
Oral acyclovir 400 mg 3 times a day for 48 hours (administered at home before neurological involvement)
Intravenous acyclovir 10 mg/kg 3 times a day for 10 days (administered after admission because of meningitis)
Outcome  
Duration of fever 2 days
Duration of neurological involvement 4 days
Duration of vescicular eruption 7 days
Duration of hospitalisation 10 days
Clinical evaluation after one month Normal with absence of neurological involvement
  1. CSF: cerebrospinal fluid; CT: computed tomography; MR: magnetic resonance; PCR: polymerase chain reaction; VZV: varicella zoster virus.