Varicella zoster virus encephalitis

Last revised by Henry Knipe on 24 Apr 2023

Varicella zoster virus (VZV) encephalitis can be due to either an immune reaction to primary infection or reactivation of latent infection in cranial nerve or dorsal root ganglia following childhood chickenpox 1.

Diagnosis

Diagnosis is often made with a combination of serum blood tests, cerebrospinal fluid samples and neuroimaging. CT and MRI brain may be normal, however, they are important in their ability to rule out other differential diagnoses ref.

Pathology

Manifestations following primary infection include: 

Reactivation occurs mainly with age-related immunosuppression, but immunocompromised patients i.e. transplant recipients are also at greater risk ref. Manifestations of secondary reactivation include 1:

Immunocompromised patients have a much wider range of manifestations and not surprisingly, these tend to be more serious. In addition to those listed above, they also include 1:

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