Unusual onset of varicella zoster reactivation with meningoencephalitis, followed by rhabdomyolysis and renal failure in a young, immunocompetent patient

Pirounaki, Maria; Liatsos, George D.; Elefsiniotis, Ioannis; Skounakis, Michail; Moulakakis, Antonios

doi:10.1080/00365540600798809

Cited by 11 publications

(11 citation statements)

References 13 publications

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“…To our knowledge, only one study has reported meningoencephalitis with VZV-related rhabdomyolysis [1]. Pirounaki et al [1] reported a case of a 27-year-old immunocompetent man with meningoencephalitis followed by VZV-related rhabdomyolysis.…”

Section: Discussionmentioning

confidence: 96%

“…Pirounaki et al [1] reported a case of a 27-year-old immunocompetent man with meningoencephalitis followed by VZV-related rhabdomyolysis. Some similarities and differences exist between this previous case and the present case.…”

Section: Discussionmentioning

confidence: 98%

“…Rhabdomyolysis itself can produce not only life-threatening complications such as renal failure, intravascular disseminated coagulation, and hyperkalemia, but also nephrotoxicity from the acyclovir, which is introduced for treating the VZV infection, but may precipitate renal failure [1].…”

Section: Discussionmentioning

confidence: 99%

“…An activated immune system may induce harmful cytokines with an efflux of myoglobin from the muscles, causing rhabdomyolysis [5]. There has been a few case reports of rhabdomyolysis associated with VZV infection; however, considering that CK levels are not routinely obtained for VZV infections, mild cases of rhabdomyolysis might have been underdiagnosed [1,[4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…Systemic reactivation of Varicella zoster virus (VZV) is rare in immunocompetent young adults, and there has been only one case report of VZV reactivation meningoencephalitis associated with rhabdomyolysis [1]. Advances in immunohistochemical analyses and the polymerase chain reaction (PCR) have widened the clinical spectrum of acute and chronic VZV reactivation [2].…”

Section: Introductionmentioning

confidence: 99%

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Varicella zoster virus meningoencephalitis accompanied by rhabdomyolysis without skin eruption

Kim

2011

Neurol Sci

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We report a case of a 38-year-old man with a Varicella zoster virus (VZV) reactivation who manifested meningoencephalitis accompanied by rhabdomyolysis without a skin eruption. During the acute phase, VZV DNA was detected in serum and cerebrospinal fluid (CSF) by the polymerase chain reaction (PCR). After 16 days, all symptoms and signs resolved, and follow-up PCR studies revealed negative conversion of VZV in the serum and CSF. We discuss the possible underlying mechanism of VZV reactivation in our patient. This is the first case report of VZV reactivation meningoencephalitis accompanied by rhabdomyolysis without skin eruption demonstrated by viral DNA in the serum and CSF.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Varicella zoster virus meningoencephalitis accompanied by rhabdomyolysis without skin eruption

Kim

2011

Neurol Sci

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Myalgia‐induced discovery of rhabdomyolysis complicating generalized varicella in an immunocompetent patient: Case report and review of the literature

Bayala,

Ayouba Tinni,

Ouedraogo

et al. 2024

Clinical Case Reports

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Key clinical messageIn a rare occurrence, primary varicella infection led to rhabdomyolysis in a 24‐year‐old with no medical history. Presenting with rash, fever, and weakness, he developed diffuse myalgia at 72 h. Elevated muscle enzymes confirmed rhabdomyolysis secondary to varicella zoster virus (VZV) infection. Treatment with acyclovir and hydration resulted in significant improvement within a month.AbstractPrimary varicella infection is rarely complicated by rhabdomyolysis. In this study, we describe a case of rhabdomyolysis complicating a VZV infection in a black subject. The patient was a 24‐year‐old black African with no particular medical history and was immunocompetent. He presented with an acute onset of generalized rash, fever, and generalized weakness. Physical examination revealed vesicular lesions typical of chickenpox. Antipyretic treatment combined with acyclovir was instituted in hospital. At the 72nd hour, diffuse myalgia developed. Muscle enzyme tests revealed CPK elevated to 40 times the upper limit of normal, LDH elevated to 2 times the upper limit of normal, ASAT and ALAT elevated to 7 times the upper limit of normal, and 2.5 times the upper limit of normal, respectively. We accepted the diagnosis of rhabdomyolysis secondary to VZV infection. The patient was given saline hydration and showed clinical and biological improvement 1 month later. A patient presenting with muscular symptoms during a VZV infection should be considered for rhabdomyolysis.

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Disseminated varicella with multiorgan failure in an immunocompetent adult

Beby‐Defaux

Chatellier

Bourgoin

et al. 2009

Journal of Medical Virology

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A case of fulminant disseminated varicella is reported in a 28-year-old immunocompetent man. He developed hepatitis, severe pneumonia, rhabdomyolysis and disseminated intravascular coagulation, followed by encephalopathy and multiorgan failure despite acyclovir therapy. He spent a total of 3.5 months in intensive care and rehabilitation units. Real-time PCR yielded a rapid diagnosis of varicella-zoster virus (VZV) infection and was used to monitor plasma viral load for 56 days. Plasma viral load peaked at 7.1 log(10)/ml on day 4 after symptom onset, then gradually declined and became undetectable after between 1 and 2 months; viral load in lung fluid followed a similar pattern. The glycoprotein E variant associated with increased VZV virulence was not detected, and the VZV thymidine kinase gene bore no major mutations associated with acyclovir resistance. This case serves as a reminder that varicella can be life-threatening in adults and that vaccination of individuals at risk remains essential.

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Unusual onset of varicella zoster reactivation with meningoencephalitis, followed by rhabdomyolysis and renal failure in a young, immunocompetent patient

Cited by 11 publications

References 13 publications

Varicella zoster virus meningoencephalitis accompanied by rhabdomyolysis without skin eruption

Varicella zoster virus meningoencephalitis accompanied by rhabdomyolysis without skin eruption

Myalgia‐induced discovery of rhabdomyolysis complicating generalized varicella in an immunocompetent patient: Case report and review of the literature

Disseminated varicella with multiorgan failure in an immunocompetent adult

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