Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report

BackgroundVaricella zoster virus (VZV) infection is a common viral illness in children, typically manifesting as chickenpox and having a benign, self-limiting course. However, severe neurological complications—such as vasculitis resulting in intracranial hemorrhage—although rare, can occur and are a...

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Main Authors: Saket Satyasham Toshniwal, Jiwan Kinkar, Anand Loya, Palash Sandeep Kotak, Sourya Acharya, Anil Wanjari
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1581803/full
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author Saket Satyasham Toshniwal
Jiwan Kinkar
Anand Loya
Palash Sandeep Kotak
Sourya Acharya
Anil Wanjari
author_facet Saket Satyasham Toshniwal
Jiwan Kinkar
Anand Loya
Palash Sandeep Kotak
Sourya Acharya
Anil Wanjari
author_sort Saket Satyasham Toshniwal
collection DOAJ
description BackgroundVaricella zoster virus (VZV) infection is a common viral illness in children, typically manifesting as chickenpox and having a benign, self-limiting course. However, severe neurological complications—such as vasculitis resulting in intracranial hemorrhage—although rare, can occur and are associated with significant morbidity and mortality.Case presentationWe present the case of a previously healthy 7-year-old boy who developed intracranial hemorrhagic vasculitis 14 days after a primary VZV infection. The child experienced sudden-onset seizures and altered sensorium. Neuroimaging showed an intracranial hemorrhage with evidence of cerebral vasculitis. Laboratory tests, cerebrospinal fluid (CSF) analysis, and serological studies confirmed a recent VZV infection. The patient was treated with antiviral therapy and corticosteroids, resulting in improvement.DiscussionThis case illustrates a rare but severe vascular complication of VZV infection in children. The pathophysiology is viral-induced inflammation of the vessels, leading to vessel wall damage, necrosis, and possible hemorrhage. Early detection through clinical suspicion, imaging, and CSF examination is essential for starting early treatment, which can change the course of the disease and improve outcomes.ConclusionIntracranial hemorrhagic vasculitis is an uncommon but serious complication of VZV infection in children. This case highlights the need to consider post-infectious vasculitis in the differential diagnosis of any child with acute neurological symptoms and a recent history of chickenpox to avoid delays in diagnosis and management.
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spelling doaj-art-595cf17ff0b04ee7aecb042db99457542025-08-20T02:36:14ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15818031581803Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case reportSaket Satyasham Toshniwal0Jiwan Kinkar1Anand Loya2Palash Sandeep Kotak3Sourya Acharya4Anil Wanjari5Department of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaDepartment of Neurology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaDepartment of General Medicine, Pad. DY Patil Hospital, Navi Mumbai, IndiaDepartment of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaDepartment of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaDepartment of General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IndiaBackgroundVaricella zoster virus (VZV) infection is a common viral illness in children, typically manifesting as chickenpox and having a benign, self-limiting course. However, severe neurological complications—such as vasculitis resulting in intracranial hemorrhage—although rare, can occur and are associated with significant morbidity and mortality.Case presentationWe present the case of a previously healthy 7-year-old boy who developed intracranial hemorrhagic vasculitis 14 days after a primary VZV infection. The child experienced sudden-onset seizures and altered sensorium. Neuroimaging showed an intracranial hemorrhage with evidence of cerebral vasculitis. Laboratory tests, cerebrospinal fluid (CSF) analysis, and serological studies confirmed a recent VZV infection. The patient was treated with antiviral therapy and corticosteroids, resulting in improvement.DiscussionThis case illustrates a rare but severe vascular complication of VZV infection in children. The pathophysiology is viral-induced inflammation of the vessels, leading to vessel wall damage, necrosis, and possible hemorrhage. Early detection through clinical suspicion, imaging, and CSF examination is essential for starting early treatment, which can change the course of the disease and improve outcomes.ConclusionIntracranial hemorrhagic vasculitis is an uncommon but serious complication of VZV infection in children. This case highlights the need to consider post-infectious vasculitis in the differential diagnosis of any child with acute neurological symptoms and a recent history of chickenpox to avoid delays in diagnosis and management.https://www.frontiersin.org/articles/10.3389/fmed.2025.1581803/fullstrokechildvasculitic strokevasculitisinfectionvaricella zoster virus
spellingShingle Saket Satyasham Toshniwal
Jiwan Kinkar
Anand Loya
Palash Sandeep Kotak
Sourya Acharya
Anil Wanjari
Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report
Frontiers in Medicine
stroke
child
vasculitic stroke
vasculitis
infection
varicella zoster virus
title Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report
title_full Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report
title_fullStr Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report
title_full_unstemmed Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report
title_short Intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report
title_sort intracranial hemorrhagic vasculitis in a child with varicella zoster virus infection a case report
topic stroke
child
vasculitic stroke
vasculitis
infection
varicella zoster virus
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1581803/full
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AT anandloya intracranialhemorrhagicvasculitisinachildwithvaricellazostervirusinfectionacasereport
AT palashsandeepkotak intracranialhemorrhagicvasculitisinachildwithvaricellazostervirusinfectionacasereport
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