Herpes Zoster Meningitis in a Young,Immunocompetent Adult |
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| Authors: | Ryan Bateman Robin Naples |
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| Affiliation: | 1. Pediatric Emergency Medicine, UT Southwestern Medical Center, Dallas, Texas;2. Trauma Department, Children''s Health, Dallas, Texas;3. Pediatric Surgery, UT Southwestern Medical Center, Dallas, Texas;1. Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA;2. Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA;3. Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA;1. Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan;2. Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan;3. Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan |
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| Abstract: | BackgroundVaricella-zoster virus is typically encountered in the emergency department (ED) in two forms: varicella (chickenpox) in children and zoster (shingles) in older adults. Zoster is infrequently encountered in young, healthy adults, and neurological complications are extremely rare.Case ReportWe describe a case of a previously healthy 36-year-old woman who presented to the ED with fever, nuchal rigidity, and headache 4 days after being diagnosed with herpes zoster and started on oral valacyclovir. Lumbar puncture confirmed herpes zoster meningitis. Despite initiation of antivirals within 48 h of symptom onset, progression to zoster meningitis occurred.Why Should an Emergency Physician Be Aware of This?Emergency physicians must be aware that neurological complications of varicella zoster can develop despite initiation of oral antivirals. These patients must be identified in the ED, as admission for intravenous antivirals is indicated. |
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| Keywords: | meningitis zoster herpes varicella |
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