Acute severe headache: Association of herpes zoster meningitis and sinus vein thrombosis

Authors

Keywords:

Children, Headache, Herpes zoster meningitis, Immunocompetent, Sinus vein thrombosis

Abstract

The development of neurological complications related to varicella zoster virus (VZV) is rare, especially in immunocompetent children. We report a case of a 14-year-old male patient who presented with severe headache and diagnosed with acute aseptic meningitis and sinus vein thrombosis caused by reactivated VZV infection. Magnetic resonance (MR) venography identified limited flow, consistent with a thrombus in the right sigmoid sinus. Pressure of cerebrospinal fluid (CSF) was measured as high, with the PCR meningitis panel positive for VZV. These results show an association of VZV meningitis and sinus vein thrombus. Pediatric cases associated with aseptic meningitis and cerebral venous sinus thrombosis to varicella zoster reactivation have not yet been reported in the literature

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References

Yasuda R, Minami K, Ogawa A, Okada H, Terakawa R, Koike Y, et al. Herpes zoster and meningitis in an immunocompetent child: a case report. J Med Case Rep. 2019;13(1):182.

Cunha BA, Warren-Favorito H, Mickail N. Unusually severe varicella zoster (VZV) virus viral (aseptic) meningitis in an unimmunized, immunocompetent host with chickenpox. Heart Lung. 2011;40(4):349-51.

Kleinschmidt-DeMasters BK, Gilden DH. The expanding spectrum of herpesvirus infections of the nervous system. Brain Pathol. 2001;11(4):440-51.

Bredlich RO, Alfke K, Brickenstein H, Pillekamp H, Peter RU. Meningeale Reizung--eine Komplikation des Herpes zoster [Meningeal irritation--a complication of herpes zoster]. Dtsch Med Wochenschr. 1998;123(36):1035-8.

Petursson G, Helgason S, Gudmundsson S, Sigurdsson JA. Herpes zoster in children and adolescents. Pediatr Infect Dis J. 1998;17(10):905-8.

Gershon AA, Gershon MD, Breuer J, Levin MJ, Oaklander AL, Griffiths PD. Advances in the understanding of the pathogenesis and epidemiology of herpes zoster. J Clin Virol. 2010;48(1):2-7.

Gnann JW Jr. Varicella-zoster virus: atypical presentations and unusual complications. J Infect Dis. 2002;186(1):91-8.

Ibrahim W, Elzouki AN, Husain A, Osman L. Varicella Zoster Aseptic Meningitis: Report of an Atypical Case and Literature Review. Am J Case Rep. 2015;16:594-7.

Johnson RW, Whitton TL. Management of herpes zoster (shingles) and postherpetic neuralgia. Expert Opin Pharmacother. 2004;5(3):551-9.

Mehta A, Arora A, Sharma M, Malik R, Porwal YC. Hemorrhagic Stroke and Cerebral Venous Thrombosis: Rare Neurological Sequelae of Chickenpox Infection. Ann Indian Acad Neurol. 2018;21(3):228-32.

Sada S, Kammineni A, Kanikannan MA, Afshan J. Cerebral sinus venous thrombosis: a rare complication of primary Varicella zoster virus. Neurol India. 2012;60(6):645-6.

Zhu R, Fang C, Wang J, He X. Acute Herpes Zoster Followed by Cerebral Venous Sinus Thrombosis. Neurol India. 2020;68(1):219-21.

Jain R, Deveikis J, Hickenbottom S, Mukherji SK. Varicella-zoster vasculitis presenting with intracranial hemorrhage. AJNR Am J Neuroradiol. 2003;24(5):971-4.

Itrat A, Shoukat S, Kamal AK. Pathophysiology of cerebral venous thrombosis--an overview. JPMA. The Journal of the Pakistan Medical Association. 2006;56(11):506-8.

Alataby H, Gautam R, Yuan M, Nfonoyim J. Varicella-Zoster as a Cause of Aseptic Meningitis in an Immunocompetent Young Patient With Skin Rash. Cureus. 2020;12(6):e8745.

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Published

2022-04-01

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Section

Case Report

How to Cite

1.
Yurdakul Ertürk E, İnce H, Albayrak D. Acute severe headache: Association of herpes zoster meningitis and sinus vein thrombosis. J Surg Med [Internet]. 2022 Apr. 1 [cited 2024 Apr. 19];6(4):524-6. Available from: https://jsurgmed.com/article/view/978248