title: [Meningoencephalitis caused by varicella zoster virus].
abstract: Varicella zoster virus (VZV) belongs to the group of herpes viruses. It can cause a number of nervous system infections. We present 2 of 4 patients seen recently suffering from acute meningoencephalitis, in which VZV proved to be the infectious agent. The first patient was a 57-year-old woman with headache, vomiting, and sudden aggressiveness. The second patient was a 60-year-old man with headache, nausea, and vomiting. Neither patient had skin eruptions usually associated with VZV reactivation, nor had either recently suffered from herpes zoster. Both patients had in their cerebrospinal fluid a lymphocytic pleocytosis, a decreased glucose concentration and and an elevated protein concentration. The patients recovered within a few days of starting intravenous treatment with aciclovir 10 mg/kg 3 times daily for one week. Recent literature shows that VZV is a common pathogen in meningoencephalitis and is probably underestimated as a putative cause of this condition. VZV meningoencephalitis usually has a mild course, but serious complications have been reported. Patients present with headache and usually fever. Nuchal rigidity and meningeal irritation are not always present. Since the advent of the PCR technique, VZV has been readily demonstrable. Anti-viral treatment is advised despite the lack of placebo-controlled studies, and may be combined with prednisone.
authors.affiliation: Afdeling Neurologie, Atrium Medisch Centrum Heerlen, The Netherlands.
authors.forename: Nico J
authors.initials: NJ
authors.lastname: Weerkamp
authors.forename: Koos
authors.initials: K
authors.lastname: Keizer
authors.forename: C H E Edwin
authors.initials: CH
authors.lastname: Boel
authors.forename: Maarten C
authors.initials: MC
authors.lastname: de Rijk
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D020804:Encephalitis, Varicella Zoster / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D005260:Female; D006261:Headache / Q000209:etiology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D008875:Middle Aged; D016133:Polymerase Chain Reaction
chemical_list: D000998:Antiviral Agents; D000212:Acyclovir