Varicella Zoster aseptic meningitis: Report of an atypical case in an immunocompetent patient treated with oral valacyclovir

IDCases
Martin GnoniRodrigo Aguilar

Abstract

Varicella Zoster when described has the typical presentation of a dermatomal distribution of a rash and can further lead to CNS complications. This can be treated accordingly with the proper protocol, but if the presentation is atypical and the protocol is challenged or changed per specific patient outcomes, new developments can occur. Here we present a case of a 29-year-old Caucasian female that presented to the emergency department with headache, photophobia, and chills for 5 days. She was previously healthy and immunocompetent; CSF PCR analysis revealed a VZV infection causing acute aseptic meningitis with no shingles rash eruption on physical examination. The patient was not willing to stay hospitalized for the duration of the treatment. This gave us an opportunity to treat her with an oral, rather than IV, antiviral. The patient was successfully treated with oral valacyclovir 2 g Q6H after only receiving two days of IV acyclovir. To the best of our knowledge, this is the first reported case of a patient with VZV-associated meningitis successfully treated with oral valacyclovir.

Citations

Aug 25, 2020·Journal of Investigative Medicine High Impact Case Reports·Mohammed Ali FalukKhalid Abusaada
Jun 11, 2020·Case Reports in Infectious Diseases·Suyash DawadiBhupendra Shah
Feb 14, 2021·The Journal of Emergency Medicine·Ryan Bateman, Robin Naples
Jun 23, 2021·Expert Opinion on Pharmacotherapy·Marise BremerAngharad G Davis

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BETA
PCR

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