title: Isolated acute dysphagia due to varicella-zoster virus.
abstract: We present a case of zoster sine herpete causing isolated acute dysphagia in an immunocompetent patient. The interest of this paper is the atypical presentation of varicella-zoster virus reactivation. A 77-year-old woman presented with a 3-day history of fever and worsening dysphagia for both liquid and solid foods. Cerebrospinal fluid examination revealed lymphocytic pleocytosis and PCR amplified varicella-zoster virus DNA with high antibody titers in both serum and cerebrospinal fluid. The panel was suggestive of a cranial neuritis due to varicella-zoster virus, involved cranial nerves, even in the absence of a cutaneous and mucosal rash. Varicella-zoster virus reactivation should be included in the differential diagnosis of isolated or multiple cranial nerve palsies, with or without zosteriform skin lesions. A prompt etiologic diagnosis can lead to early administration of antiviral therapy.
authors: Neurological Department, A. Manzoni Hospital, Lecco, Italy. Electronic address: vittorio.mantero@hotmail.com.
authors: Vittorio
authors: V
authors: Mantero
authors: Neurological Department, A. Manzoni Hospital, Lecco, Italy.
authors: Andrea
authors: A
authors: Rigamonti
authors: Division of Otorhinolaryngology, A. Manzoni Hospital, Lecco, Italy.
authors: Sergio
authors: S
authors: Valentini
authors: Neurological Department, A. Manzoni Hospital, Lecco, Italy.
authors: Anna
authors: A
authors: Fiumani
authors: Neurological Department, A. Manzoni Hospital, Lecco, Italy.
authors: Francesca
authors: F
authors: Piamarta
authors: Division of Infectious Diseases, A. Manzoni Hospital, Lecco, Italy.
authors: Paolo
authors: P
authors: Bonfanti
authors: Neurological Department, A. Manzoni Hospital, Lecco, Italy.
authors: Andrea
authors: A
authors: Salmaggi
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis / Q000097:blood; D002555:Cerebrospinal Fluid / Q000276:immunology / Q000821:virology; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification* / Q000502:physiology; D006801:Humans; D009443:Neuritis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D014775:Virus Activation
chemical_list: D000914:Antibodies, Viral
keywords: Cerebrospinal fluid examination; Cranial neuritis; Dysphagia; Varicella-zoster virus; Viral infections