Cao Li-Juan, Zheng Yi-Ming, Li Fan, Hao Hong-Jun, Gao Feng
Department of Neurology, Peking University First Hospital, Beijing 100034, China.
Department Acupuncture and Moxibustion, Huguosi Traditional Chinese Medicine Hospital Attached to Beijing Traditional Chinese Medicine University, Beijing 100034, China.
World J Clin Cases. 2023 Oct 16;11(29):7101-7106. doi: 10.12998/wjcc.v11.i29.7101.
Varicella-zoster virus (VZV) is a common viral infection, but meningitis is a rare complication of VZV infection. The cerebrospinal fluid glucose of viral meningitis is usually within the normal range, which is different from bacteria, fungi, and cancerous meningitis. This paper reports a case of VZV meningitis with hypoglycorrhachia and the relevant literature was reviewed.
We report a case of an immunocompetent 39-year-old male, presenting with severe headache and fevers, without meningeal signs or exanthem, found to have VZV meningitis by the metagenomic next-generation sequencing of cerebrospinal fluid. The cerebrospinal fluid analysis revealed hypoglycorrhachia (cerebrospinal fluid glucose of 2.16) and he was treated successfully with intravenous acyclovir. Our literature review identified only ten cases diagnosed with VZV meningitis with hypoglycorrhachia previously reported to date in the English literature whose cerebrospinal fluid glucose was from 1.6 to 2.7mmol/L, with a ratio of cerebrospinal fluid to serum glucose from 0.30 to 0.49.
Although rare, the cerebrospinal fluid of patients with VZV meningitis may have hypoglycorrhachia, which broadens the understanding of the disease.
水痘带状疱疹病毒（VZV）感染较为常见，但脑膜炎是VZV感染的一种罕见并发症。病毒性脑膜炎患者的脑脊液葡萄糖通常在正常范围内，这与细菌性、真菌性和癌性脑膜炎不同。本文报告一例伴有脑脊液低糖的VZV脑膜炎病例，并对相关文献进行综述。
我们报告一例39岁免疫功能正常男性病例，该患者出现严重头痛和发热，无脑膜刺激征或皮疹，通过脑脊液宏基因组下一代测序发现患有VZV脑膜炎。脑脊液分析显示脑脊液低糖（脑脊液葡萄糖为2.16），经静脉注射阿昔洛韦治疗成功。我们的文献综述发现，迄今为止，英文文献中仅报道了10例确诊为伴有脑脊液低糖的VZV脑膜炎病例，其脑脊液葡萄糖为1.6至2.7mmol/L，脑脊液与血清葡萄糖比值为0.30至0.49。
虽然罕见，但VZV脑膜炎患者的脑脊液可能出现低糖，这拓宽了对该疾病的认识。
