{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T21:16:44Z","timestamp":1760044604359,"version":"3.40.4"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,1,27]]},"abstract":"<jats:p>Viral meningitis caused by varicella-zoster virus (VZV) is an uncommon neurological complication of herpes zoster. It may occur before or after the onset of the vesicular rash along the dermatomal distribution, which is the classic presentation of herpes zoster. We describe a case of a 51-year-old immunocompetent Caucasian man who presented with neck and severe right-sided facial pain. Eight days later, he had photophobia and papular rash on his forehead. Cerebrospinal fluid (CSF) examination confirmed aseptic meningitis and CSF PCR detected the presence of VZV DNA. Neurological complications of VZV infection, such as aseptic meningitis, may be difficult to diagnose and can cause delay in treatment, especially in cases with late onset of dermatological manifestations of herpes zoster. Definite diagnosis requires evidence of acute VZV infection in blood or cerebrospinal fluid.<\/jats:p>","DOI":"10.1136\/bcr-2014-208056","type":"journal-article","created":{"date-parts":[[2015,2,17]],"date-time":"2015-02-17T14:09:00Z","timestamp":1424182140000},"page":"bcr2014208056","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Varicella-zoster meningitis with a late-onset of skin eruption"],"prefix":"10.1136","volume":"2015","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3662-4136","authenticated-orcid":false,"given":"Anawin","family":"Sanguankeo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sikarin","family":"Upala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suthanya","family":"Sornprom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natanong","family":"Thamcharoen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,2,17]]},"reference":[{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1957.02980030041010"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6166.818"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.41.8.1215"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.4","first-page":"41","article-title":"Polymerase chain reaction for diagnosis of varicella zoster virus central nervous system infections without skin manifestations","volume":"100","author":"Bergstrom","year":"1996","journal-title":"Scand J Infect Dis Suppl"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2009.07.014"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.6","doi-asserted-by":"publisher","DOI":"10.1080\/13550280902725550"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1302674"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.8","doi-asserted-by":"crossref","first-page":"168943","DOI":"10.1155\/2013\/168943","article-title":"An immunocompetent patient with a vesicular rash and neurological symptomatology","volume":"2013","author":"Cooper","year":"2013","journal-title":"Case Rep Med"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.9","doi-asserted-by":"crossref","first-page":"1622.e1","DOI":"10.1016\/j.ajem.2013.06.021","article-title":"Herpes zoster meningitis with multidermatomal rash in an immunocompetent patient","volume":"31","author":"Goyal","year":"2013","journal-title":"Am J Emerg Med"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.10","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-200x.2000.01227.x"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.11","doi-asserted-by":"publisher","DOI":"10.1159\/000150535"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.12","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/155.5.959"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.13","doi-asserted-by":"crossref","unstructured":"Gnann JW Jr . Antiviral therapy of varicella-zoster virus infections. In: Arvin A , Campadelli-Fiume G , Mocarski E , et al . eds. Human herpesviruses: biology, therapy, and immunoprophylaxis. Cambridge: Cambridge University Press, 2007. Chapter 65. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK47401\/","DOI":"10.1017\/CBO9780511545313.066"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.14","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-11-199906010-00017"},{"key":"2025042705220342000_2015.feb17_1.bcr2014208056.15","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1002\/jmv.23902","article-title":"Clinical features, outcomes, and cerebrospinal fluid findings in adult patients with central nervous system (CNS) infections caused by varicella-zoster virus: comparison with enterovirus CNS infections","volume":"86","author":"Hong","year":"2014","journal-title":"J Med Virol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-208056","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T12:22:14Z","timestamp":1745756534000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-208056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,17]]},"references-count":15,"alternative-id":["10.1136\/bcr-2014-208056"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-208056","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2015,2,17]]}}}