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Article

Varicella Zoster Viral Meningitis in an Immune-competent Young Female without a Rash or a Fever

1Acute Medicine Department, Princess Royal University Hospital, King’s College Trust, London, UK


American Journal of Medical Case Reports. 2021, Vol. 9 No. 5, 278-280
DOI: 10.12691/ajmcr-9-5-4
Copyright © 2021 Science and Education Publishing

Cite this paper:
Abdalla Khalil, Khalil Hossenbux, Yusuf Ibidapo. Varicella Zoster Viral Meningitis in an Immune-competent Young Female without a Rash or a Fever. American Journal of Medical Case Reports. 2021; 9(5):278-280. doi: 10.12691/ajmcr-9-5-4.

Correspondence to: Abdalla  Khalil, Acute Medicine Department, Princess Royal University Hospital, King’s College Trust, London, UK. Email: abdallak59@gmail.com

Abstract

Viral meningitis is the most common identified cause of meningitis in the United Kingdom and represents a challenge to diagnose early and a burden on health care service. A young healthy female was admitted to the hospital with a headache, nausea, vomiting, meningeal irritation, and a strong family history of a cerebral aneurysm. She had no fever or rash and her cerebrospinal fluid CSF showed lymphocytic pleocytosis with high protein and normal glucose. Initially, she was treated empirically with antiviral and antibiotics for acute meningitis and her final workup confirmed the varicella zoster viral meningitis. Rarely, Varicella zoster viral meningitis can affect immune-competent patients. It can also rarely present without a skin lesion or fever. Virology study of the cerebrospinal fluid may reveal the diagnosis of viral meningitis early and reduce the health care burden.

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