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Zoster sine herpete causing encephalomyelitis.

G L Mancardi, G Melioli, F Traverso

    Italian Journal of Neurological Sciences
    |February 1, 1987
    PubMed
    Summary
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    Central nervous system herpes zoster infection can occur without skin rash. Diagnosis was confirmed by detecting specific antibodies against Varicella-zoster virus (VZV) in cerebrospinal fluid.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Virology

    Background:

    • Encephalomyelitis is a complex neurological condition affecting the brain and spinal cord.
    • Herpes zoster, caused by the Varicella-zoster virus (VZV), typically presents with a characteristic skin rash.
    • Central nervous system (CNS) involvement in VZV infections can lead to severe neurological complications.

    Observation:

    • A case study involving a patient diagnosed with encephalomyelitis is presented.
    • The patient exhibited laboratory evidence suggestive of a central nervous system herpes zoster infection.
    • Notably, the patient presented without any characteristic cutaneous lesions (skin rash).

    Findings:

    • The diagnosis of VZV CNS infection was supported by serological testing.

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  • Intrathecal synthesis of specific antibodies against Varicella-zoster virus (VZV) was detected.
  • This indicates the virus was actively replicating within the central nervous system.

    • Implications:

    • This case highlights that VZV can cause CNS infections like encephalomyelitis without the typical skin manifestations.
    • Early and accurate diagnosis of VZV CNS infections is crucial for timely and effective treatment.
    • Serological evidence of intrathecal antibody synthesis is a valuable diagnostic tool for VZV CNS disease, especially in the absence of cutaneous lesions.