Abstract
Meningoencephalitis caused by varicella zoster virus is a rare pathology that presents due to the reactivation of the virus in the organism
OBJECTIVE:To describe the clinical presentation of two patients with VZV neuroinfection presented after a SARS CoV-2 infection.
CASE REPORT:The first case is a 59 year old male with previous moderate SARS CoV-2 infection who presented meningoencephalitis and was diagnosed with Ramsay Hunt's Syndrome. The second case is a 37 year old female with previous SARS CoV-2 infection who presented with an acute onset headache and was documented with VZV neuroinfection.
References
Salamano R, Lewin S. Las encefalitis herpéticas: encefalitis producidas por la familia herpes. Arch Med Int. 2011;33(3):49-58. http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-423X2011000300001&lng=es
Arruti M, Piñeiro LD, Salicio Y, Cilla G, Goenaga MA, López de Munain A. Incidence of varicella zoster virus infections of the central nervous system in the elderly: a large tertiary hospital-based series (2007-2014). J Neurovirol. 2017;23(3):451-9. https://doi.org/10.1007/s13365-017-0519-y.
Misiara Alvarez AE, Ruiz Hernández I, Vázquez Hurtado JF, Misiara Alvarez N. Encefalitis por virus varicela zoster: A propósito de un caso. Rev Med Electrón. 2009; 31(5). http://scielo.sld.cu/scielo.php?script-sci_arttext&pid-S1684-18242009000500015&lng=es
Reichelt M, Brady J, Arvin AM. The replication cycle of varicella-zoster virus: analysis of the kinetics of viral protein expression, genome synthesis, and virion assembly at the single-cell level. J Virol. 2009; 83(8):3904-18. https://doi.org/10.1128/jvi.02137-08.
Grahn A, Studahl M. Varicella-zoster virus infections of the central nervous system - Prognosis, diagnostics and treatment. J Infect. 2015;71(3):281-93. https://doi.org/10.1016/j.jinf.2015.06.004.
Gilden D. Varicella zoster virus and central nervous system syndromes. Herpes. 2004;11 Suppl 2:89A-94A.
Nakajima H, Hara M, Morita A, Kamei S. Neurologic complications of varicella-zoster virus infection. En: Thomasine R, editor. Human herpesvirus infection - biological features, transmission, symptoms, diagnosis and treatment. 2020; https://doi.org/10.5772/intechopen.83036
Outteryck O, Sénéchal O, Berteloot D, Delalande I, Mounier-Vehier F. Cerebral vasculitis secondary to Varicella-Zoster virus infection. Rev Neurol. 2005;161(8-9):836-9. https://doi.org/10.1016/s0035-3787(05)85144-6.
Ramirez-Salas JE, Benito-Orejas JI, Bauer M, Viveros-Díez P, Cifuentes-Navas VA, Duque-Holguera V. Manifestaciones clínicas del síndrome de Ramsay-Hunt en una serie de 20 casos. Revista ORL. 2020;12(1):3-17. https://doi.org/10.14201/orl.22750.
Sharifian-Dorche M, Huot P, Osherov M, Wen D, Saveriano A, Giacomini PS, et al. Neurological complications of coronavirus infection; a comparative review and lessons learned during the COVID-19 pandemic. J Neurol Sci. 2020;417:117085. https://doi.org/10.1016/j.jns.2020.117085.
Patel P, Undavia A, Choudry R, Zhang Y, Prabhu AM. COVID-19 Associated with concomitant varicella zoster viral encephalitis. Neurol Clin Pract. 2020;11(2):e219-e221. https://doi.org/10.1212/cpj.0000000000000902.
Ferreira A, Romão T, Macedo Y, Pupe C, Nascimento O. COVID-19 and herpes zoster co-infection presenting with trigeminal neuropathy. Eur J Neurol. 2020;27(9):1748-50. https://doi.org/10.H11/ene.14361.
Maia C, Marques N, de Lucena E, de Rezende L, Martelli D, Martelo-Júnior H. Increased number of Herpes Zoster cases in Brazil related to the COVID-19 pandemic. Int J Infect Dis. 2021;104:732-8. https://doi.org/10.10167j.ijid.2021.02.033.
Algaadi SA. Herpes zoster and COVID-19 infection: a coincidence or a causal relationship? Infection. 2021;22:1-5. https://doi.org/10.1007/s15010-021-01714-6.
Tuppeny M. Viral meningitis and encephalitis. Crit Care Nurs Clin North Am. 2013;25(3):363-80. https://doi.org/10.1016/j.ccell.2013.04.003.
Nagel M, Niemeyer C, Bubak A. Central nervous system infections produced by varicella zoster virus. Curr Opin Infect Dis. 2020;33(3):273-8. https://doi.org/10.1097/QCO.0000000000000647.
Chen L, Xu Y, Liu C, Huang H, Zhong X, Ma C, et al. Clinical features of aseptic meningitis with varicella zoster virus infection diagnosed by next-generation sequencing: case reports. BMC Infect Dis. 2020;20(1):435. https://doi.org/10.1186/s12879-020-05155-8.
Tyler K. Acute viral encephalitis. N EnglJ Med. 2018;379(6):557-66. https://doi.org/10.1056/nejmra1708714.
López-Amor L, Escudero D, Fernández J, Martín-Iglesias L, Viña L, Fernández-Suárez J et al. Diagnóstico de meningitis/ encefalitis en UCI con sistema de PCR múltiple. ¿Es tiempo de cambio? Rev Esp Quimioter. 2019;32(3):246-53.
Nye B, Ward T. Clinic and emergency room evaluation and testing of headache. Headache. 2015;55(9):1301-8. https://doi.org/10.1111/head.12648.
Do T, Remmers A, Schytz H, Schankin C, Nelson S, Obermann M, et al. Red and orange flags for secondary headaches in clinical practice. Neurology. 2019;92(3):134-44. https://doi.org/10.1212/WNL.0000000000006697.
Debiasi R, Tyler K. Viral meningitis and encephalitis. Continuum. 2006;12:58-94. https://doi.org/10.1212/01.CON.0000290450.11098.b1.
Sigfrid L, Perfect C, Rojek A, Longuere K, Lipworth S, Harriss E, et al. A systematic review of clinical guidelines on the management of acute, community-acquired CNS infections. BMC Med. 2019;17(1):170. https://doi.org/10.1186/s12916-019-1387-5.
Pahud, BA, Glaser CA, Dekker, CL, Arvin AM, Schmid, DS. Varicella zoster disease of the central nervous system: epidemiological, clinical, and laboratory features 10 years after the introduction of the varicella vaccine. Infect Dis. 2011;203(3):316-23. https://doi.org/10.1093/infdis/jiq066.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
