Gilad Oded, Shefer-Averbuch Noa, Garty Ben Zion
Department of Pediatrics, Schneider Children's Medical Center of Israel, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Pediatrics, Schneider Children's Medical Center of Israel, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
J Child Neurol. 2015 May;30(6):793-5. doi: 10.1177/0883073814535500. Epub 2014 May 19.
Primary varicella infection may be associated with neurologic complications, such as cerebritis and meningoencephalitis. Several cases of varicella infection with elevated intracranial pressure have been reported. We describe a 13-year-old immunocompetent girl who presented with a clinical picture of headaches and elevated intracranial pressure as the only manifestation of primary varicella zoster infection. The working diagnosis at first was pseudotumor cerebri based on complaints of headache of 2 weeks' duration, in addition to vomiting and papilledema, without fever or skin eruption. On lumbar puncture, opening pressure was 420 mmH2O, but mild pleocytosis and mildly elevated protein level ruled out the diagnosis of pseudotumor cerebri. Our patient had no history of previous varicella infection, and she did not receive the varicella zoster vaccine. Serology tests, done on admission and repeated 2 months later, suggested primary varicella infection. The literature on varicella infection associated with pseudotumor cerebri or elevated intracranial pressure is reviewed.
原发性水痘感染可能与神经系统并发症相关，如大脑炎和脑膜脑炎。已有数例水痘感染伴颅内压升高的报道。我们描述了一名13岁免疫功能正常的女孩，其以头痛和颅内压升高为临床表现，是原发性水痘带状疱疹感染的唯一表现。最初的临床诊断为假性脑瘤，依据是持续2周的头痛主诉，伴有呕吐和视乳头水肿，无发热或皮疹。腰椎穿刺时，初压为420 mmH2O，但轻度细胞增多和蛋白水平轻度升高排除了假性脑瘤的诊断。我们的患者既往无水痘感染史，也未接种水痘带状疱疹疫苗。入院时及2个月后复查的血清学检查提示原发性水痘感染。本文对与假性脑瘤或颅内压升高相关的水痘感染文献进行了综述。
