A case of herpes zoster which onset was throat pain and subsequently developed meningoencephalitis

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  • Tamiya Akiko
    Department of Otorhinolaryngology, Tokyo Woman’s Medical University
  • Tachikawa Mayako
    Department of Otorhinolaryngology, Tokyo Woman’s Medical University
  • Yamamura Yukie
    Department of Otorhinolaryngology, Tokyo Woman’s Medical University
  • Nonaka Manabu
    Department of Otorhinolaryngology, Tokyo Woman’s Medical University

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Other Title
  • 咽頭痛で初発し髄膜脳炎に至った帯状疱疹症例
  • イントウツウ デ ショハツ シ ズイマク ノウエン ニ イタッタ タイジョウホウシンショウレイ

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Abstract

The varicella-zoster virus （VZV） can cause meningitis and lead to multiple central nerve involvement. A 69-year-old man complaining of sore throat and progressively worsening difficulty with oral intake for 6 days was referred to our hospital with a diagnosis of varicella zoster pharyngitis. A physical examination identified vesicular eruptions on the left auricle, external ear canal, and left side of the oropharynx, accompanied by scattered vesicles throughout his body surface. However, there was no evidence of cranial nerve involvement. Therefore, he was hospitalized in a depressurized room, and 1,500mg of Acicrobil was administered per day. By day 6 of hospitalization, most of the vesicles had scabbed over, but left vocal cord palsy manifested. On day 7 to 10 of hospitalization, palsy of cranial nerves Ⅶ, Ⅸ, Ⅹ, and Ⅺ appeared. The results of cerebrospinal fluid examination suggested that the patient suffered from VZV meningoencephalitis. Therefore, additional Acicrobil and Methylprednisolone therapy was administered. On day 41 of hospitalization, the patient was discharged on foot. However, paralysis of the left side of his facial nerve and accessory nerve remained.

Journal

  • Stomato-pharyngology

    Stomato-pharyngology 33 (2), 111-117, 2020

    Japan Society of Stomato-pharyngology

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