{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T04:52:18Z","timestamp":1766119938623,"version":"3.48.0"},"reference-count":12,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Herpesviruses are double-stranded DNA viruses that belong to the Herpesviridae family and are capable of infecting both humans and animals. A defining feature of these viruses is their ability to establish lifelong latency within host cells, with the potential to reactivate in response to triggers such as immunosuppression or physiological stress. Among the eight identified human herpesviruses, the Varicella-Zoster Virus (VZV), also known as human herpesvirus type 3, is responsible for causing chickenpox during the initial infection and shingles on reactivation. In the case we observed, VZV manifested primarily with neurological symptoms such as headache, elevated intracranial pressure, cerebrospinal fluid (CSF) pleocytosis and unilateral papilloedema in the absence of fever or a skin rash. Treatment with intravenous acyclovir produced a marked improvement in the clinical condition and CSF findings.<\/jats:p>","DOI":"10.1136\/bcr-2025-268188","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T04:05:22Z","timestamp":1766117122000},"page":"e268188","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unusual presentation of Varicella-Zoster Virus infection in paediatrics"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6343-9078","authenticated-orcid":false,"given":"Ahmed Aaid","family":"Osman","sequence":"first","affiliation":[{"name":"Paediatrics, East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5891-3675","authenticated-orcid":false,"given":"Fuad Fajer Fuad","family":"Kara\u2019een","sequence":"additional","affiliation":[{"name":"Paediatrics, East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wimal","family":"Nettikumara","sequence":"additional","affiliation":[{"name":"Paediatrics, East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lalani","family":"Heva","sequence":"additional","affiliation":[{"name":"Paediatrics, East Sussex Healthcare NHS Trust, Saint Leonards-on-Sea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"2025121820051745000_18.12.e268188.1","doi-asserted-by":"crossref","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","article-title":"Varicella zoster virus infection","volume":"1","author":"Gershon","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"2025121820051745000_18.12.e268188.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0962"},{"key":"2025121820051745000_18.12.e268188.3","doi-asserted-by":"crossref","DOI":"10.3390\/v13102018","article-title":"Recent Issues in Varicella-Zoster Virus Latency","volume":"13","author":"Kennedy","year":"2021","journal-title":"Viruses"},{"key":"2025121820051745000_18.12.e268188.4","doi-asserted-by":"publisher","DOI":"10.1086\/589747"},{"key":"2025121820051745000_18.12.e268188.5","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1007\/s10096-016-2605-0","article-title":"Diagnosis, antiviral therapy, and prophylaxis of varicella-zoster virus infections","volume":"35","author":"Sauerbrei","year":"2016","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2025121820051745000_18.12.e268188.6","article-title":"Varicella-Zoster Virus Meningitis and Encephalitis: An Understated Cause of Central Nervous System Infections","volume":"12","author":"Alvarez","year":"2020","journal-title":"Cureus"},{"key":"2025121820051745000_18.12.e268188.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-020-02244-0","article-title":"Encephalitis due to herpes zoster without rash in an immunocompetent 12-year-old girl: case report and review of the literature","volume":"20","author":"Ciancia","year":"2020","journal-title":"BMC Pediatr"},{"key":"2025121820051745000_18.12.e268188.8","doi-asserted-by":"publisher","DOI":"10.1177\/0883073809336296"},{"key":"2025121820051745000_18.12.e268188.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-019-3986-3","article-title":"Detection of varicella-zoster virus from cerebrospinal fluid using advanced fragment analysis in a child with encephalitis: a case report","volume":"19","author":"Song","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2025121820051745000_18.12.e268188.10","article-title":"A Rare Case of Varicella-Zoster Virus Encephalitis Presenting With Lost Ability to Play the Piano in an Immunocompetent Pediatric Patient","volume":"15","author":"Le","year":"2023","journal-title":"Cureus"},{"key":"2025121820051745000_18.12.e268188.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(79)80791-X"},{"key":"2025121820051745000_18.12.e268188.12","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1007\/BF00261615","article-title":"Raised ICP in a child with cryptococcal meningitis: CT evidence of a distal CSF block","volume":"12","author":"Schoeman","year":"1996","journal-title":"Childs Nerv Syst"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T04:05:24Z","timestamp":1766117124000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":12,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,18]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-268188"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268188","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}