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10.1016_j.idcr.2022.e01484.pdf (532.38 kB)

Varicella-Zoster meningitis with normal CSF cellularity: A rare case report

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submitted on 2023-12-06, 11:37 and posted on 2023-12-07, 07:23 authored by Bana Sabbagh, Mohammed Najdat Seijari, Mhd Kutaiba Albuni, Munsef Barakat, Gamal B. Alfitori

Varicella-zoster virus (VZV) meningitis is a one of the manifestations of VZV reactivation which usually presents with fever, headache, and is sometimes preceded by a dermatomal vesicular rash. CSF analysis is the cornerstone investigation in helping to identify the causative organism or in orienting the physician toward a possible agent. CSF analysis in Viral meningitis usually reveals lymphocytic pleocytosis. However, normal CSF analysis with viral meningitis -despite being rare- has been reported especially with bacterial causes. Therefore, a first CSF puncture cannot rule out infection and a second one might be warranted if there is still high suspicion of viral meningitis with no diagnosis made by PCR. Here we present a case of an 89-year-old female who had signs and symptoms of meningitis with normal CSF analysis. However, polymerase chain reaction (PCR) was positive for VZV. The patient was treated accordingly, and she recovered fully.

Other Information

Published in: IDCases
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1016/j.idcr.2022.e01484

Funding

Open Access funding provided by the Qatar National Library.

History

Language

  • English

Publisher

Elsevier

Publication Year

  • 2022

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License.

Institution affiliated with

  • Hamad Medical Corporation
  • Hamad General Hospital - HMC

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