Herpes Zoster Meningitis in a Young, Immunocompetent Adult.
herpes
meningitis
varicella
zoster
Journal
The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
06
10
2020
revised:
17
12
2020
accepted:
23
12
2020
pubmed:
14
2
2021
medline:
9
7
2021
entrez:
13
2
2021
Statut:
ppublish
Résumé
Varicella-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. We 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.
Sections du résumé
BACKGROUND
BACKGROUND
Varicella-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 REPORT
METHODS
We 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.
Identifiants
pubmed: 33579658
pii: S0736-4679(20)31420-7
doi: 10.1016/j.jemermed.2020.12.029
pii:
doi:
Substances chimiques
Valacyclovir
MZ1IW7Q79D
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e99-e101Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.