Varicella Zoster Virus-Associated Meningitis as a Rebound Varicella Zoster Disease after Antiviral Discontinuation

Varicella zoster virus (VZV)-associated meningitis is usually progressive and can be fatal, and early diagnosis and aggressive treatment with intravenous antivirals such as acyclovir (ACV) are required in immunocompromised patients. Patients receiving corticosteroids and immunosuppressive therapy ha...

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Main Authors: Tetsuko Sato (Author), Takenobu Yamamoto (Author), Yumi Aoyama (Author)
Format: Book
Published: Karger Publishers, 2021-02-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Tetsuko Sato  |e author 
700 1 0 |a Takenobu Yamamoto  |e author 
700 1 0 |a Yumi Aoyama  |e author 
245 0 0 |a Varicella Zoster Virus-Associated Meningitis as a Rebound Varicella Zoster Disease after Antiviral Discontinuation 
260 |b Karger Publishers,   |c 2021-02-01T00:00:00Z. 
500 |a 1662-6567 
500 |a 10.1159/000512710 
520 |a Varicella zoster virus (VZV)-associated meningitis is usually progressive and can be fatal, and early diagnosis and aggressive treatment with intravenous antivirals such as acyclovir (ACV) are required in immunocompromised patients. Patients receiving corticosteroids and immunosuppressive therapy have a significantly higher risk of VZV-associated meningitis. In this report, we describe an unusual case of herpes zoster (HZ) in a young woman who was first diagnosed during tapering of prednisone for dermatomyositis. The skin lesions affected the left L2 and L3 dermatomes, which is unusual in VZV-associated meningitis. Despite showing a good rapid response to antivirals, she developed VZV-associated meningitis immediately after discontinuation of ACV. This phenomenon is often called rebound VZV reactivation disease and occurs after discontinuation of antivirals. This case was notable in that the affected dermatomes were distant from the cranial nerves. Thus, progression of HZ to VZV reactivation-associated meningitis can occur even in appropriately treated HZ patients. Continuation of antivirals beyond 1 week in patients on immunosuppressive therapy may be associated with a decreased risk of severe rebound VZV disease, such as VZV-associated meningitis. 
546 |a EN 
690 |a varicella zoster virus 
690 |a herpes zoster 
690 |a meningitis 
690 |a rebound phenomenon 
690 |a acyclovir 
690 |a Dermatology 
690 |a RL1-803 
655 7 |a article  |2 local 
786 0 |n Case Reports in Dermatology, Vol 13, Iss 1, Pp 148-153 (2021) 
787 0 |n https://www.karger.com/Article/FullText/512710 
787 0 |n https://doaj.org/toc/1662-6567 
856 4 1 |u https://doaj.org/article/d7aa5a21fd96489a83d30896dda85d2b  |z Connect to this object online.