Journal of NeuroVirology

, Volume 23, Issue 4, pp 621–624 | Cite as

Diplopia as isolated presentation of varicella zoster central nervous system reactivation

  • Cosmo Del BorgoEmail author
  • Valeria Belvisi
  • Maria Beatrice Valli
  • Antonio Currà
  • Irene Pozzetto
  • Massimiliano Sepe
  • Claudio Maria Mastroianni
Case Report


Here, we report a patient who developed diplopia secondary to a right cranial nerve III and IV palsy, as well as fever and headache. Cerebrospinal fluid analysis (CSF) showed high varicella-zoster virus (VZV)-DNA viral load (>300,000,000 copies/ml). VZV antibodies in CSF was ≥1:16. Diagnosis of neurological reactivation of VZV infection was made without the presence of characteristic vesicular rash. Quantitative real-time PCR for VZV and intrathecal dosage of VZV IgM and IgG should be performed in cases suspected for viral encephalitis and also in all patients with not otherwise attributable cranial nerve lesions.


Varicella-zoster virus (VZV) reactivation Diplopia 


Compliance with ethical standards

Conflict of interests

The authors declare that they have no conflict of interest.


Written informed consent has been obtained from the patient for publication of this Case report. A copy of the written consent is available for check by the Editor, if needed.


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Copyright information

© Journal of NeuroVirology, Inc. 2017

Authors and Affiliations

  1. 1.Infectious Diseases UnitS.M. Goretti HospitalLatinaItaly
  2. 2.Department of Public Health and Infectious DiseasesSapienza UniversityRomeItaly
  3. 3.Laboratory of Virology, National Institute for Infectious Diseases, “L. Spallanzani”, I.R.C.C.SRomeItaly
  4. 4.Academic Neurology Unit, A. Fiorini Hospital, Department of Medical-Surgical Sciences and BiotechnologiesSapienza University of RomeTerracinaItaly
  5. 5.Ophtalmology UnitS.M.Goretti HospitalLatinaItaly

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