[Meningeal irritation--a complication of herpes zoster].
METHODS
A previously healthy 26-year-old man complained of gradually increasing headache after an attack of flu. After 4 days an erythema with papules but no blisters was noted in the area of distribution of the left 10th thoracic nerve. As a child he had varicella (chickenpox) without complications.


METHODS
Lymphocytic pleocytosis and evidence of an abnormal blood-brain barrier were noted in cerebrospinal fluid (CSF). Serology for varicella zoster virus revealed an IgG titre of > 7400 IU/l in serum and 21 IU/l in CSF. The corresponding IgM titres were negative.


METHODS
The headaches and cutaneous changes regressed under i.v. treatment with acyclovir, 10 mg/kg body weight, 3 x daily for 10 days. Repeat CSF examination after 10 days showed merely minimal residual changes of inflammation.


CONCLUSIONS
This case illustrates the risk of severe neurological complications of herpes zoster infection. A seemingly minor rash with headache must be correctly diagnosed and immediate high-dosage acyclovir treatment instituted to prevent life-threatening and severe complications of herpes zoster meningitis or encephalitis.
Abteilung Dermatologie, Klinikums der Universität Ulm.
R O
RO
Bredlich
K
K
Alfke
H
H
Brickenstein
H
H
Pillekamp
R U
RU
Peter
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D000998:Antiviral Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000166:cytology; D004890:Erythema / Q000209:etiology; D006261:Headache / Q000209:etiology*; D006562:Herpes Zoster / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008587:Meningitis, Viral / Q000209:etiology* / Q000517:prevention & control; D013900:Thoracic Nerves
D000914:Antibodies, Viral; D000998:Antiviral Agents; D007074:Immunoglobulin G; D000212:Acyclovir
Meningeale Reizung--eine Komplikation des Herpes zoster.