Chen Andreana, Perswani Prinka, Kumari Raj, Haque Siddiqi M, Zhang Min
Internal Medicine, California University of Science and Medicine, Colton, USA.
Internal Medicine, University of California, Riverside, Riverside, USA.
Cureus. 2024 Jul 23;16(7):e65226. doi: 10.7759/cureus.65226. eCollection 2024 Jul.
Varicella-zoster virus (VZV) is a virus of the alphaherpesvirus family that is one of the common causes of infectious encephalitis worldwide, especially among those who are immunocompromised. In this case report, we discuss a case of a 55-year-old female with end-stage renal disease presenting with altered mental status and weakness. She was recently diagnosed with herpes zoster on oral acyclovir and multiple scattered dermatomal rashes on presentation. Cerebral spinal fluid analysis showed neutrophilic pleocytosis, high glucose and protein, and anti-VZV Immunoglobulin G (IgG) antibodies. She was started on treatment early with acyclovir and demonstrated good clinical improvement afterward two weeks. This case highlights to importance of performing lumbar puncture and looking for anti-VZV antibodies to rule out encephalitis in patients with altered mental status and starting acyclovir treatment early.
水痘带状疱疹病毒（VZV）是一种α疱疹病毒科病毒，是全球传染性脑炎的常见病因之一，尤其是在免疫功能低下的人群中。在本病例报告中，我们讨论了一名55岁终末期肾病女性患者，她出现精神状态改变和虚弱症状。她最近被诊断为带状疱疹，正在口服阿昔洛韦，就诊时出现多处散在的皮节皮疹。脑脊液分析显示中性粒细胞增多、葡萄糖和蛋白质水平升高，以及抗VZV免疫球蛋白G（IgG）抗体。她早期开始使用阿昔洛韦治疗，两周后临床症状有明显改善。该病例强调了对精神状态改变的患者进行腰椎穿刺并检测抗VZV抗体以排除脑炎，并尽早开始阿昔洛韦治疗的重要性。
