title: Varicella zoster virus infection presenting as isolated diplopia: a case report.
abstract: BACKGROUND
  Involvement of trochlear nerve during Varicella Zoster Virus (VZV) Infection has been rarely described, and always in association with skin rash.
  
  
  METHODS
  We describe the case of a patient with VZV infection presenting as isolated diplopia due to fourth cranial nerve palsy. The diagnosis has been obtained through the application of a standardized molecular diagnostic panel, and diplopia resolved after specific antiviral and corticosteroid therapy.
  
  
  CONCLUSIONS
  This case evidences that clinicians should be aware of atypical VZV infection, even in the absence of the typical skin rash.
authors.affiliation: Clinical Department, First Division, National Institute for Infectious Diseases Lazzaro Spallanzani, Via Portuense 292, 00149, Rome, Italy. raffaella.pisapia@inmi.it
authors.forename: Raffaella
authors.initials: R
authors.lastname: Pisapia
authors.forename: Alessia
authors.initials: A
authors.lastname: Rianda
authors.forename: Andrea
authors.initials: A
authors.lastname: Mariano
authors.forename: Angela
authors.initials: A
authors.lastname: Testa
authors.forename: Simonetta
authors.initials: S
authors.lastname: Galgani
authors.forename: Laura
authors.initials: L
authors.lastname: Vincenzi
authors.forename: Amina
authors.initials: A
authors.lastname: Abdeddaim
authors.forename: Alessandra
authors.initials: A
authors.lastname: Oliva
authors.forename: Pasquale
authors.initials: P
authors.lastname: Narciso
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004172:Diplopia / Q000175:diagnosis*; D006562:Herpes Zoster / Q000175:diagnosis* / Q000188:drug therapy; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D025202:Molecular Diagnostic Techniques; D020432:Trochlear Nerve Diseases / Q000175:diagnosis*
chemical_list: D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents