Varicella zoster virus cerebellitis without skin manifestations in an immunocompetent adult

Abstract

The varicella zoster virus (VZV) is a ubiquitous, neurotropic pathogen capable of reactivation from sensory ganglion cells to cause dermatomal herpes zoster infection, alongside a range of pathologies within the central nervous system. The presence of VZV cerebellitis without skin manifestations, however, is exceedingly rare in immunocompetent adults.We report a case of VZV cerebellitis in an immunocompetent woman in her 70s, in the absence of a rash. The patient presented with a 2-week history of progressive gait ataxia, headache and mild confusion. Serological tests and neuroimaging were unremarkable. Diagnosis was confirmed through cerebrospinal fluid (CSF) analysis which revealed lymphocytosis and the presence of VZV DNA on PCR analysis. The patient showed symptomatic improvement following empirical acyclovir treatment, corroborated by favourable CSF analysis 10 days post-treatment initiation.Infective aetiology, including VZV, should be considered in patients presenting with acute cerebellar ataxia, even in immunocompetent adults with an absence of dermatological signs.

Therapeutic effect of computed tomography-guided dorsal root ganglion pulsed radiofrequency regulation combined with platelet-rich plasma injection on postherpetic neuralgia: A retrospective study

“…The study on the pathogenesis of PHN found that the VZV lurking in DRG proliferated, destroyed nerve axons, and caused nerve tissue damage [16]. These damaged sensory nerves produce abnormal nerve impulses, which continue to be input through DRG, resulting in increased pain sensitivity of peripheral and central nerves [7]. In addition to conventional drug treatment, minimally invasive treatment of PHN has also been widely recognized, which can relieve pain and improve the quality of life and is widely used in the treatment of postherpetic neuralgia [24].…”