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 |