Abstract
Varicella-zoster virus (VZV) meningitis is sometimes associated with herpes zoster, which is also associated with various other infectious diseases. However, there are limited case reports of VZV meningitis with concomitant infectious diseases. Herein, we report a unique case of VZV meningitis concomitant with a pyogenic liver abscess. VZV meningitis was associated with herpes zoster ophthalmicus, Klebsiella pneumoniae bacteremia, and liver abscess. When VZV meningitis is suspected, clinicians should be aware of its relatively rare epidemiology, nonspecific presentation, and many background risks shared with other infections and should never omit thorough examinations to rule out other infectious causes.
Similar content being viewed by others
Abbreviations
- VZV :
-
Varicella-zoster virus
- CSF :
-
Cerebrospinal fluid
- CT :
-
Computed tomography
- DNA :
-
Deoxyribonucleic acid
References
Guignard AP, Greenberg M, Lu C, Rosillon D, Vannappagari V (2014) Risk of herpes zoster among diabetics: a matched cohort study in a US insurance claim database before introduction of vaccination, 1997–2006. Infection 42:729–735. https://doi.org/10.1007/s15010-014-0645-x
Ihekwaba UK, Kudesia G, McKendrick MW (2008) Clinical features of viral meningitis in adults: significant differences in cerebrospinal fluid findings among herpes simplex virus, varicella zoster virus, and enterovirus infections. Clin Infect Dis 47:783–789. https://doi.org/10.1086/591129
Ilie A, Popescu R, Stoica E (2013) Pyogenic liver abscess in a diabetic patient with fever of unknown origin. BMC Infect Dis 13:97. https://doi.org/10.1186/1471-2334-13-S1-P97
Kaewpoowat Q, Salazar L, Aguilera E, Wootton SH, Hasbun R (2016) Herpes simplex and varicella zoster CNS infections: clinical presentations, treatments and outcomes. Infection 44:337–345. https://doi.org/10.1007/s15010-015-0867-6
Kaplan GG, Gregson DB, Laupland KB (2004) Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess. Clin Gastroenterol Hepatol 2:1032–1038. https://doi.org/10.1016/s1542-3565(04)00459-8
Kim SH, Choi SM, Kim BC, Choi KH, Nam TS, Kim JT, Lee SH, Park MS, Kim SJ (2017) Risk factors for aseptic meningitis in herpes zoster patients. Ann Dermatol 29:283–287. https://doi.org/10.5021/ad.2017.29.3.283
Liu L, Chen W, Lu X, Zhang K, Zhu C (2016) Pyogenic liver abscess: a retrospective study of 105 cases in an emergency department from East China. J Emerg Med 52:409–416. https://doi.org/10.1016/j.jemermed.2016.09.026
Marra F, Parhar K, Huang B, Vadlamudi N (2020) Risk factors for herpes zoster infection: a meta-analysis Open Forum Infect Dis 7 https://doi.org/10.1093/ofid/ofaa005
Mei-Ling S, Kuan-Fu L, Sung-Mao T, Cheng-Li LM, Shih-Wei L (2016) Herpes zoster correlates with pyogenic liver abscesses in Taiwan. Biomedicine (taipei) 6:22. https://doi.org/10.7603/s40681-016-0022-4
Pasedag T, Weissenborn K, Wurster U, Stangel M, Skripuletz T (2014) Varicella zoster virus meningitis in a young immunocompetent adult without rash: a misleading clinical presentation. Case Rep Neurol Med 2014:686218. https://doi.org/10.1155/2014/686218
Pergam SA, Limaye AP, Infectious Diseases Community AST, of Practice, (2009) Varicella zoster virus (VZV) in solid organ transplant recipients. Am J Transplant 9:S108–S115. https://doi.org/10.1111/j.1600-6143.2009.02901.x
Rahimian J, Wilson T, Oram V, Holzman RS (2004) Pyogenic liver abscess: recent trends in etiology and mortality. Clin Infect Dis 39:1654–1659. https://doi.org/10.1086/425616
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Oe, H., Watanabe, M., Sasaki, M. et al. Varicella-zoster virus meningitis coincident with bacteremia caused by liver abscess: a case report. J. Neurovirol. 28, 606–608 (2022). https://doi.org/10.1007/s13365-022-01086-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13365-022-01086-z