title: Varicella-zoster meningoencephaloradiculoneuropathy in an immunocompetent young woman.
abstract: The clinical manifestations of varicella-zoster virus infections can be divided into primary infection with chickenpox and reactivated infection with dermatomal shingles, disseminated herpes zoster, zoster sine herpete and varicella-zoster virus encephalitis, meningitis and vasculopathy. We present a case of zoster sine herpete leading to meningitis with cranial and peripheral nerve palsies. A 17-year-old woman was admitted to hospital with intermittent fever, drowsiness, slowness and subsequent frontal headache and horizontal diplopia. Cerebrospinal fluid examination revealed lymphocytic pleocytosis and PCR amplified varicella-zoster virus DNA. Laboratory and clinical findings were suggestive of meningoencephaloradiculoneuropathy, stemming from varicella-zoster virus and affecting cranial and peripheral nerves. Only 5% of patients with zoster develop cranial and peripheral nerve palsies. Diagnosis is imperative in order to initiate prompt antiviral therapy so as to minimize morbidity and the risk of death.
authors.affiliation: Department of Neurosciences, Niguarda Ca' Granda Hospital, Milan, Italy. vittorio.mantero@hotmail.com
authors.forename: Vittorio
authors.initials: V
authors.lastname: Mantero
authors.forename: Luisa
authors.initials: L
authors.lastname: De Toni Franceschini
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Lillia
authors.forename: Angelo
authors.initials: A
authors.lastname: Guccione
authors.forename: Ignazio
authors.initials: I
authors.lastname: Santilli
authors.forename: Elio
authors.initials: E
authors.lastname: Agostoni
mesh_terms: D000293:Adolescent; D003389:Cranial Nerve Diseases / Q000276:immunology / Q000821:virology*; D005260:Female; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007121:Immunocompetence; D008581:Meningitis / Q000276:immunology / Q000821:virology*; D010243:Paralysis / Q000276:immunology / Q000821:virology*; D031368:Zoster Sine Herpete / Q000276:immunology / Q000821:virology*