Pre-eruptive varicella cerebellitis confirmed by PCR
F Dangond1, E Engle, L Yessayan
1Department of Neurology, Children's Hospital, Boston, Massachusetts, USA.
Pediatric Neurology
|November 1, 1993
Summary
Diagnosing pre-eruptive varicella cerebellitis early is crucial. Polymerase chain reaction (PCR) testing of blood and cerebrospinal fluid can rapidly confirm varicella-zoster virus infection before skin symptoms appear.
Area of Science:
- Neurology
- Virology
- Infectious Diseases
Background:
- Pre-eruptive varicella cerebellitis diagnosis relies on exposure history and clinical assessment.
- Traditional confirmation involves skin manifestations and antibody seroconversion, often delaying diagnosis.
- Early diagnosis of viral cerebellitis or ataxia can prevent unnecessary interventions.
Observation:
- A case of suspected pre-eruptive varicella cerebellitis was investigated.
- Polymerase chain reaction (PCR) analysis was performed on peripheral blood leukocytes and cerebrospinal fluid.
- The patient later developed characteristic varicella skin manifestations.
Findings:
- PCR confirmed varicella-zoster virus DNA in both blood and cerebrospinal fluid.
- This provided rapid etiological confirmation of the cerebellitis.
- Skin lesions appeared 5 days after neurological symptoms and 15 days post-exposure.
Implications:
- PCR testing offers a valuable tool for early and rapid confirmation of pre-eruptive varicella cerebellitis.
- Timely diagnosis can guide appropriate patient management and avoid unnecessary procedures.
- This diagnostic approach is particularly useful in cases presenting with neurological symptoms preceding rash.
More Related Videos
Related Concept Videos
01:28Herpes
Herpes simplex type 1 (HSV‑1) is a widespread pathogen responsible for orolabial lesions. It is an enveloped, double-stranded DNA (dsDNA) virus belonging to the family Herpesviridae. Once the virus infects a host cell, its double‑stranded DNA genome is delivered into the nucleus, where a coordinated cascade of immediate‑early, early, and late gene expression directs viral DNA replication, structural protein synthesis, and virion assembly. After primary infection of epithelial cells, HSV-1...
01:20Chickenpox
Chickenpox is an acute, highly contagious disease caused by the varicella-zoster virus (VZV), a double-stranded DNA virus belonging to the Herpesviridae family. Its transmission occurs primarily through the inhalation of respiratory droplets or direct contact with vesicular fluid from skin lesions. The incubation period typically ranges from 10 to 21 days, during which the virus replicates and disseminates through sequential phases within the host. Although generally self-limiting in children,...
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:17Poliomyelitis
Poliomyelitis is caused by poliovirus, a small, non-enveloped, positive-sense RNA virus of the Picornaviridae family and Enterovirus genus. Transmission occurs primarily via the fecal-oral route, often through ingestion of contaminated water or food. The virus initially replicates in the oropharynx and intestinal mucosa, particularly in lymphoid tissues such as the tonsils, Peyer’s patches, and regional lymph nodes. Primary viremia follows, allowing dissemination throughout the body.In most...
01:27Cytomegalovirus Disease
Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...