Carey Ronald Albert Benton, Chandiraseharan Vignesh Kumar, Jasper Anitha, Sebastian Tunny, Gujjarlamudi Chrusolitha, Sathyendra Sowmya, Zachariah Anand, Abraham Asha Mary, Sudarsanam Thambu David
Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India.
Ann Indian Acad Neurol. 2017 Apr-Jun;20(2):149-152. doi: 10.4103/aian.AIAN_484_16.
Varicella zoster virus is an exclusively human neurotrophic virus. The primary infection with the virus causes varicella. The virus remains latent in nervous tissue and upon secondary activation causes a variety of syndromes involving the central nervous system (CNS) including meningoencephalitis and cerebellitis.
In this study, we looked at the epidemiology, clinical and laboratory features, and outcomes of patients who were admitted with varicella zoster of the CNS from 2005 to 2014.
There were 17 patients. Fever was present in 13 patients, seizures in 9 patients and headache and vomiting in 4 patients each. A generalized varicella rash was present in 8 out of 17 patients. A single dermatomal herpes zoster was present in seven patients. Two patients had no rash. Varicella zoster polymerase chain reaction (PCR) in cerebrospinal fluid (CSF) was done in 5 patients of which 4 were positive and 1 was negative. Nine patients had diabetes with an average glycated hemoglobin of 8.6%. Total number of deaths was five.
Patients with diabetes who develop varicella or herpes zoster may be at risk for CNS complications. The diagnosis of varicella encephalitis has to rest on a combination of clinical findings and CSF PCR, as neither the rash nor the PCR is sensitive enough to diagnose all the cases with varicella encephalitis.
水痘带状疱疹病毒是一种仅感染人类的嗜神经病毒。该病毒的初次感染会引发水痘。病毒会潜伏在神经组织中，再次激活时会导致包括脑膜脑炎和小脑炎在内的多种涉及中枢神经系统（CNS）的综合征。
在本研究中，我们观察了2005年至2014年因中枢神经系统水痘带状疱疹入院患者的流行病学、临床和实验室特征以及治疗结果。
共有17例患者。13例患者出现发热，9例患者出现癫痫发作，4例患者出现头痛和呕吐。17例患者中有8例出现全身性水痘皮疹。7例患者出现单发性皮节带状疱疹。2例患者无皮疹。对5例患者进行了脑脊液（CSF）中的水痘带状疱疹聚合酶链反应（PCR）检测，其中4例阳性，1例阴性。9例患者患有糖尿病，糖化血红蛋白平均为8.6%。死亡总数为5例。
患水痘或带状疱疹的糖尿病患者可能有发生中枢神经系统并发症的风险。水痘脑炎的诊断必须基于临床发现和脑脊液PCR结果，因为皮疹和PCR都不足以敏感地诊断所有水痘脑炎病例。
