Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult

Introduction. Aseptic meningitis can occur from different types of infections of which viral etiologies are the most common. Varicella zoster virus (VZV) nowadays is considered a familiar entity of aseptic meningitis. However, it is usually reported in immunocompromised patients. For cases of VZV me...

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Main Authors: Deesha Bhojwani, Mohamed Zakarya, Suha Abu Khalaf
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2022/5626670
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author Deesha Bhojwani
Mohamed Zakarya
Suha Abu Khalaf
author_facet Deesha Bhojwani
Mohamed Zakarya
Suha Abu Khalaf
author_sort Deesha Bhojwani
collection DOAJ
description Introduction. Aseptic meningitis can occur from different types of infections of which viral etiologies are the most common. Varicella zoster virus (VZV) nowadays is considered a familiar entity of aseptic meningitis. However, it is usually reported in immunocompromised patients. For cases of VZV meningitis that are observed, a rash has been noted before the onset of meningitis or sometimes after it. Clinical Case. We present an uncommon case of VZV meningitis in an 18-year-old immunocompetent male who did not have a rash on presentation and did not develop one during his course either. Cerebrospinal fluid showed lymphocyte-predominant leukocytosis and elevated protein with normal glucose suggestive of aseptic meningitis. Cerebrospinal fluid polymerase chain reaction (CSF PCR) was positive for VZV; cerebrospinal fluid cultures and blood cultures were negative. The patient had complete resolution of symptoms with no complications on intravenous acyclovir therapy and was discharged home on oral valacyclovir therapy. Conclusion. It is important to consider varicella zoster virus as an etiology of aseptic meningitis as clinical presentation can be without a vesicular rash and in immunocompetent patients.
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spelling doaj-art-089bc7053c324427a081b48859bf40672025-08-20T03:55:32ZengWileyCase Reports in Infectious Diseases2090-66332022-01-01202210.1155/2022/5626670Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent AdultDeesha Bhojwani0Mohamed Zakarya1Suha Abu Khalaf2University of MissouriUniversity of MissouriUniversity of MissouriIntroduction. Aseptic meningitis can occur from different types of infections of which viral etiologies are the most common. Varicella zoster virus (VZV) nowadays is considered a familiar entity of aseptic meningitis. However, it is usually reported in immunocompromised patients. For cases of VZV meningitis that are observed, a rash has been noted before the onset of meningitis or sometimes after it. Clinical Case. We present an uncommon case of VZV meningitis in an 18-year-old immunocompetent male who did not have a rash on presentation and did not develop one during his course either. Cerebrospinal fluid showed lymphocyte-predominant leukocytosis and elevated protein with normal glucose suggestive of aseptic meningitis. Cerebrospinal fluid polymerase chain reaction (CSF PCR) was positive for VZV; cerebrospinal fluid cultures and blood cultures were negative. The patient had complete resolution of symptoms with no complications on intravenous acyclovir therapy and was discharged home on oral valacyclovir therapy. Conclusion. It is important to consider varicella zoster virus as an etiology of aseptic meningitis as clinical presentation can be without a vesicular rash and in immunocompetent patients.http://dx.doi.org/10.1155/2022/5626670
spellingShingle Deesha Bhojwani
Mohamed Zakarya
Suha Abu Khalaf
Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult
Case Reports in Infectious Diseases
title Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult
title_full Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult
title_fullStr Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult
title_full_unstemmed Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult
title_short Atypical Manifestation of VZV Infection in a Vaccinated Immunocompetent Adult
title_sort atypical manifestation of vzv infection in a vaccinated immunocompetent adult
url http://dx.doi.org/10.1155/2022/5626670
work_keys_str_mv AT deeshabhojwani atypicalmanifestationofvzvinfectioninavaccinatedimmunocompetentadult
AT mohamedzakarya atypicalmanifestationofvzvinfectioninavaccinatedimmunocompetentadult
AT suhaabukhalaf atypicalmanifestationofvzvinfectioninavaccinatedimmunocompetentadult