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Development of an IFN-γ ELISpot Assay to Assess Varicella-Zoster Virus-specific Cell-mediated Immunity Following Umbilical Cord Blood Transplantation
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Encephalitis related to primary varicella-zoster virus infection in immunocompetent children

M Häusler1, L Schaade, S Kemény

  • 1Department of Pediatrics, Pediatric Neurology Division, University Hospital, RWTH Aachen, Pauwelsstr. 30, D-52074, Aachen, Germany. Haeusler@RWTH-Aachen.de

Journal of the Neurological Sciences
|March 19, 2002
PubMed

Insights

Varicella-zoster virus (VZV) encephalitis can occur in children without a rash and may lead to chronic illness. Diagnosis requires careful evaluation, as vaccination history can be misleading.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Encephalitis is a rare but serious complication of primary varicella-zoster virus (VZV) infection in immunocompetent children.
  • This report details two pediatric cases of VZV-related encephalitis.

Observation:

  • Two girls presented with focal epileptic seizures and white matter lesions.
  • One child had a typical rash and recovered well with treatment; the other lacked a rash and had a complicated, chronic course.
  • Diagnostic challenges arose due to a prior measles-mumps-rubella vaccination and absence of skin vesicles in the second patient.

Findings:

  • Diagnosis was confirmed by VZV-specific IgG seroconversion and intrathecal antibody synthesis.
  • Cerebrospinal fluid VZV PCR was negative in both cases.
  • The second patient developed progressive demyelination and erythema nodosum, requiring prolonged steroid treatment.

Implications:

  • Primary VZV infection can cause severe encephalitis without a rash, potentially leading to chronic neurological conditions like vasculitis.
  • Coincidental vaccination does not imply a causal link to neurological disease.
  • Highlights the importance of considering VZV in pediatric encephalitis, even without characteristic skin manifestations.
Abstract

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