A Case of Adult-onset Varicella PneumoniaandVaricella-zoster Virus (VZV) MeningitisResulting from a Reoccurrence of Varicella

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  • YAMASHITA Hiroyuki
    National Center for Global and Health Medicine, Division of Rheumatology
  • UEDA Yo
    National Center for Global and Health Medicine, Division of Rheumatology
  • TAKAHASHI Yuko
    National Center for Global and Health Medicine, Division of Rheumatology
  • MIMORI Akio
    National Center for Global and Health Medicine, Division of Rheumatology

Bibliographic Information

Other Title
  • 成人に発症した水痘再感染による水痘肺炎及び水痘 ―帯状疱疹ウイルス髄膜炎の1 例―
  • 症例 成人に発症した水痘再感染による水痘肺炎及び水痘 : 帯状疱疹ウイルス髄膜炎の1例
  • ショウレイ セイジン ニ ハッショウ シタ スイトウ サイカンセン ニ ヨル スイトウ ハイエン オヨビ スイトウ : タイジョウホウシンウイルス ズイマクエン ノ 1レイ
  • 水痘再感染による水痘肺炎・VZV 髄膜炎の1 例

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Description

The patient was a 74-year old male who presented with a skin rash, cough, and impaired consciousness. Adiffuse, systemic, dark red rash was observed and he was admitted. Varicella infection was diagnosed based on the varicella-zoster virus (VZV)-IgM levels. The extremely high VZV- IgG levels observed were unlikely to be present inaninitial infection and the infection was thought to be a reoccurrence. Diffuse nodular shadows measuring ≤5mm indiameter were observed on chest computed tomography (CT) ; this was consistent with the typical imaging findings of varicella pneumonia. <BR> The cerebrospinal fluid (CSF) was positive for CSF VZV-IgM antibody, CSF VZV-PCR, and CSF antibody titer index. A diagnosisofvaricella meningitis was made. When both respiratory and neurological symptoms are observed inpatients with varicella infection, it is necessary to consider a combined diagnosis of varicella pneumonia and varicella meningitis/encephalitis and perform chest imaging and a CSF examination. Repeated asymptomaticre-infection isconsidered necessary in order to maintaina life long immunity to varicella ; however, the opportunities for asymptomaticre-infection are decreasing with the declining birth rate and trend toward small families. As a result, reoccurrences of varicella infection in the elderly are expected to increase with rapidlyincreasing longevity.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 86 (3), 306-309, 2012

    The Japanese Association for Infectious Diseases

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