Varicella zoster virus cerebellitis without skin manifestations in an immunocompetent adult

Enwo, Oby Otu, Ibrahim, Dina, Boughton, Matthew and Coyle-Gilchrist, Ian ORCID: (2023) Varicella zoster virus cerebellitis without skin manifestations in an immunocompetent adult. BMJ Case Reports, 16 (1). ISSN 1757-790X

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The varicella zoster virus (VZV) is a ubiquitous, neurotropic pathogen capable of reactivation from sensory ganglion cells to cause dermatomal herpes zoster infection, alongside a range of pathologies within the central nervous system. The presence of VZV cerebellitis without skin manifestations, however, is exceedingly rare in immunocompetent adults. We report a case of VZV cerebellitis in an immunocompetent woman in her 70s, in the absence of a rash. The patient presented with a 2-week history of progressive gait ataxia, headache and mild confusion. Serological tests and neuroimaging were unremarkable. Diagnosis was confirmed through cerebrospinal fluid (CSF) analysis which revealed lymphocytosis and the presence of VZV DNA on PCR analysis. The patient showed symptomatic improvement following empirical acyclovir treatment, corroborated by favourable CSF analysis 10 days post-treatment initiation. Infective aetiology, including VZV, should be considered in patients presenting with acute cerebellar ataxia, even in immunocompetent adults with an absence of dermatological signs.

Item Type: Article
Uncontrolled Keywords: cerebellum,headache (including migraines),infection (neurology),medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 07 Aug 2023 10:31
Last Modified: 07 Aug 2023 10:31
DOI: 10.1136/bcr-2022-252636

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