Concurrence of Chicken Pox and Varicella Zoster Virus Encephalitis in an Immunocompetent Female: A Case Report

Abstract

Varicella-zoster virus (VZV) causes primary infection of chickenpox and when reactivated produces shingles along with the dermatomal distribution of the affected nerve. Immunocompromised and unvaccinated elderly people are at a higher risk of infection. Varicella can be prevented by vaccination. One of the potential complications of VZV infection is encephalitis. Our 44 years old immunocompetent patient development altered sensorium and seizures, five days after the onset of characteristic chickenpox lesions. CSF analysis was consistent with viral encephalitis. PCR of the CSF confirmed the diagnosis of VZV encephalitis. MRI reported bilateral periventricular small vessel ischemic changes. The patient was treated with injectable acyclovir for 14 days and prednisolone for 5 days with resulting dramatic clinical improvement. Anticonvulsants were given to control the seizures. The patient was discharged on the 15th day of admission with almost complete recovery without developing neurological sequelae.