J Korean Geriatr Soc.  2004 Mar;8(1):40-42.

A Case of He rpes Zoster Meningitis with Involving Multiple Dermatomes

• Han DC
• Park JH
• Shin WC
• Lee YB
• Park HM
• Shin DJ

Abstract

Herpes zoster is manifested by varicella zoster virus(VZV) that involve nerve ganglions. It may be self limited, but some may have complications or sequelae, such as postherpetic neuralgia, optic neuritis, external ocular motor nerve palsy, facial nerve palsy, encephalitis or hemiplegia. It usually involves posterior root ganglia, but there are few case reports involving multiple dermatome with meningitis simultaneously. We report a patient with herpes zoster meningitis involving with multiple dermatome. A 64 year-old female presented with intractable headache, vomiting, and multifocal skin eruptions. Physical examination showed multiple vesicular eruptions on right forehead and upper limb along the dermatomes of V1, C4, C5, C6, C7. There was no localizing or lateralizing sign except for neck stiffness. Brain CT showed no abnormal finding. In the CSF study, the opening pressure was 200 mmH2O and cell count was 36/mm3 in RBC, 1,043/mm3 in WBC(95% lympho-dorminant). The level of protein and glucose were 671mg/dL, 127 mg/dL(serumglucose 270 mg/dL), respectively. It was positive in VZV-PCR, and was negative in tumor marker studies. Under the diagnosis of Herpes zoster meningitis, she was treated and improved with antiviral agent(acyclovir). We report a patient with herpes zoster meningitis involving polydermatomes simultaneously.

Keyword

Herpes zoster; Meningitis; Dermatome

MeSH Terms

Brain
Cell Count
Chickenpox
Diagnosis
Encephalitis
Facial Paralysis
Female
Forehead
Ganglia
Ganglion Cysts
Glucose
Headache Disorders
Hemiplegia
Herpes Zoster*
Humans
Meningitis*
Middle Aged
Neck
Neuralgia, Postherpetic
Optic Neuritis
Paralysis
Physical Examination
Skin
Upper Extremity
Vomiting
Glucose