title: Varicella Zoster Virus Cerebellitis Without a Rash in an Immunocompetent 85-Year-Old Patient.
abstract: BACKGROUND
  Reactivation of the varicella zoster virus (VZV) in adults rarely presents with neurological symptoms without a rash. To our knowledge, so far, only 3 additional cases of VZV cerebellitis, which presented without a rash and were proven by cerebrospinal fluid analysis, have been reported in the literature.
  
  
  METHODS
  An immunocompetent 85-year-old patient presented with a new-onset tremor. He had no rash, had a normal brain computed tomography and magnetic resonance imaging, and had minimal cerebrospinal fluid findings. Eventually, he was diagnosed as having varicella zoster virus cerebellitis only on the basis of a virological examination.
  
  
  CONCLUSIONS
  The manifestation of a new-onset tremor and gait ataxia should raise a suspicion of cerebellitis caused by VZV, even in the absence of cutaneous manifestations or typical imaging findings.
authors.affiliation: Departments of *Internal Medicine †Infectious Disease Unit ‡Neurology, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Smadar
authors.initials: S
authors.lastname: Shilo
authors.forename: Yonit
authors.initials: Y
authors.lastname: Wiener-Well
authors.forename: Isabelle
authors.initials: I
authors.lastname: Korn-Lubetzki
mesh_terms: D000369:Aged, 80 and over; D002524:Cerebellar Ataxia / Q000175:diagnosis* / Q000821:virology*; D005076:Exanthema / Q000150:complications; D006562:Herpes Zoster / Q000150:complications*; D014645:Herpesvirus 3, Human; D006801:Humans; D008297:Male