Hemorrhagic Meningitis Due to Varicella-Zoster Virus: A Case Report With Clinical, Cytologic, and Radiologic
Vineet Gorolay1, David Martens2, Laveniya Satgunaseelan3
1Department of Radiology, Royal Prince Alfred Hospital, Sydney, AUS.
Cureus
|December 8, 2022
Summary
Hemorrhagic meningitis caused by varicella-zoster virus (VZV) is rare but can occur in immunocompromised individuals. This case highlights VZV meningitis presenting with subarachnoid hemorrhage and neurological complications.
Area of Science:
- Neurology
- Infectious Diseases
- Neurovirology
Background:
- Varicella-zoster virus (VZV) can cause diverse central nervous system (CNS) complications.
- Hemorrhagic VZV meningitis is an underreported manifestation of VZV CNS disease.
Observation:
- An immunocompromised patient presented with multidermatomal zoster, myelitis, and neurapraxia.
- Radiological findings included superficial siderosis and leptomeningeal enhancement on MRI.
- Cerebrospinal fluid analysis revealed hemorrhage and lymphocytic pleocytosis.
Findings:
- The patient was diagnosed with subarachnoid hemorrhage secondary to VZV meningitis.
- This case demonstrates a rare presentation of VZV infection involving the CNS.
Implications:
- This report expands the known spectrum of VZV-associated CNS complications.
- Recognizing hemorrhagic VZV meningitis is crucial for timely diagnosis and management in immunocompromised patients.
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