Meningitis with polymerase chain reaction for varicella zoster positivity in cerebrospinal flid of a young immunocompetent adult

ABSTRACTMeningitis caused by varicella zoster virus (VZV) is quite rare among young immunocompetent adults though immunocompromised patients are often seen to be affected by reactivation of VZV presenting with primary clinical features of dermatomal rashes and neurological sequelae. Here, we report the clinical scenario of a young, healthy male who had presented with fever, headache, and onset of dermatomal rashes later than the fever and was eventually diagnosed to be a case of VZV meningitis. We would like to highlight the fact that even young immunocompetent patients though rarely, might contract VZV meningitis and clinicians should have a high index of suspicion and keen eyes to catch the more obvious features of VZV infection on complete physical examination and must not harbor any reservations in ordering polymerase chain reaction for VZV DNA or initiating aggressive antiviral therapy.

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Adolescent COVID-19-Associated Fatal Rhabdomyolysis

Journal of Primary Care & Community Health ◽

10.1177/2150132720985641 ◽

2020 ◽

Vol 11 ◽

pp. 215013272098564

Author(s):

Huda Anwar ◽

Anwaar Al Lawati

Keyword(s):

Polymerase Chain Reaction ◽

Global Health ◽

Respiratory Tract ◽

Sore Throat ◽

Shortness Of Breath ◽

Past Medical History ◽

Chain Reaction ◽

Viral Illness ◽

Polymerase Chain ◽

High Index Of Suspicion

Coronavirus disease 2019 (COVID-19) has become an urgent global health priority. Although most patients with COVID-19 manifest with fever and respiratory tract symptoms, COVID-19 infections may also involve other organs and extrarespiratory manifestations, including cardiac, gastrointestinal, hepatic, renal, and neurological symptoms. This case describes a 16-year-old boy who presented with fever, sore throat, myalgia, and subsequently with shortness of breath. A diagnosis of COVID-19 was confirmed by polymerase chain reaction. His condition deteriorated and he died within 3 days of admission. An evaluation of his past medical history confirmed an episode of viral illness which had progressed to myositis and rhabdomyolysis 1 year prior. Clinicians should be aware of this complication and maintain a high index of suspicion in cases of COVID-19 presenting with extrapulmonary symptoms.

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Reactivation of varicella zoster infection presenting as acute retinal necrosis post COVID 19 vaccination in an Asian Indian male

European Journal of Ophthalmology ◽

10.1177/11206721211046485 ◽

2021 ◽

pp. 112067212110464

Author(s):

Sai Bhakti Mishra ◽

Padmamalini Mahendradas ◽

Ankush Kawali ◽

Srinivasan Sanjay ◽

Rohit Shetty

Keyword(s):

Polymerase Chain Reaction ◽

Asian Indian ◽

Acute Retinal Necrosis ◽

Viral Reactivation ◽

Aqueous Sample ◽

Chain Reaction ◽

Varicella Zoster ◽

Polymerase Chain ◽

Indian Male ◽

Varicella Zoster Infection

Purpose: To present the clinical features of a rare case of varicella zoster infection following one dose of Coronavirus Disease 2019 (COVID-19) vaccination in an elderly Asian Indian male. Methods: Retrospective observational case report. Results: A 71-year-old gentleman presented to us with complaints of reduced vision associated with redness and pain in his right eye for 1 week. On examination he revealed a right eye pan uveitis picture with circumcorneal congestion, multiple fine keratic precipitates, anterior chamber cells and flare, vitritis and widespread areas of acute retinal necrosis. His left eye was within normal limits. Ten days prior to the presentation he had received the first dose of COVID-19 vaccine following which he had developed fever for 2 days that preceded the red eye. The patient’s aqueous sample tested positive for varicella zoster virus (VZV) by nested polymerase chain reaction (PCR) method. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in reverse transcriptase polymerase chain reaction (RT-PCR) assay from the aqueous and also from the nasopharyngeal swab was negative. Conclusion and significance: To the best of our knowledge this is the earliest description of a case that has a viral reactivation following COVID-19 vaccination. Elderly people with pre-existing comorbidities, may be at a risk of both primary coronavirus infection and unconceivable risk of aberrant immune reactions leading to a different virus infection or reactivation need to be kept in mind. We present a possible link between SARS-CoV-2 virus vaccination and varicella zoster reactivation in this patient.

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RAPID DIAGNOSIS OF VARICELLA ZOSTER INFECTION USING THE POLYMERASE CHAIN REACTION

Southern Medical Journal ◽

10.1097/00007611-199109001-00066 ◽

1991 ◽

Vol 84 (Supplement) ◽

pp. 20

Author(s):

Robert Purvis ◽

Peter Rady ◽

Stephen K. Tyring

Keyword(s):

Polymerase Chain Reaction ◽

Rapid Diagnosis ◽

Chain Reaction ◽

Varicella Zoster ◽

Polymerase Chain ◽

Varicella Zoster Infection

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Varisela pada Dewasa, Kehamilan, dan Kondisi Imunokompromais

Jurnal Kedokteran Meditek ◽

10.36452/jkdoktmeditek.v27i1.1938 ◽

2021 ◽

Vol 27 (1) ◽

pp. 81-86

Author(s):

Mikhael San Putra Wijanarko

Keyword(s):

Polymerase Chain Reaction ◽

Chain Reaction ◽

Varicella Zoster ◽

Polymerase Chain

Varisela merupakan eksantema vesikular yang sangat menular akibat infeksi akut primer eksogen dari virus varisela zoster pada individu yang rentan. Varisela lebih sering menyerang anak-anak dengan usia kurang dari 10 tahun. Tinjauan pustaka ini bertujuan untuk mengetahui kondisi klinis dan terapi varisela pada dewasa, kehamilan dan kondisi imunokompromais. Pada dewasa, varisela biasanya lebih berat dengan mortalitas yang lebih tinggi dibandingkan anak-anak, dimana transmisi yang terjadi melalui droplet atau aerosol dari saluran napas. Masa inkubasinya berkisar antara 10-21 hari. Gejala diawali oleh fase prodromal, kemudian terjadi erupsi kulit yang polimorfik dengan progresifitasnya yang cepat. Pemeriksaan penunjang dapat berupa pemeriksaan Tzank smear, polymerase chain reaction, kultur, dan lain-lain. Varisela pada kehamilan akan mengancam kesehatan ibu dan janin, sedangkan pada pasien imunokompromais, morbiditas dan mortalitas akibat varisela meningkat. Pneumonia varisela merupakan komplikasi varisela yang serius pada dewasa. Pengobatan menggunakan antivirus asiklovir, valasiklovir, dan famsiklovir. Pencegahan dapat dilakukan dengan vaksinasi, varicella zoster immunoglobuline, dan terapi antivirus profilaksis, sehingga pengobatan yang tepat dan upaya pencegahan dengan vaksinasi pada kelompok dewasa yang rentan perlu dilakukan.

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