Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A case of acute aseptic meningitis associated with herpes zoster

대상포진에 의한 무균성 수막염 1예

  • Kim, Myong A (Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital) ;
  • Yu, Rita Miyoung (Yonsei University College of Medicine, Severance Children's Hospital) ;
  • Kim, Kee Hyuck (Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital) ;
  • Chung, Hee Jung (Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital)
  • 김명아 (국민건강보험공단 일산병원 소아청소년과) ;
  • 유리타 (연세대학교 의과대학 소아과학교실) ;
  • 김기혁 (국민건강보험공단 일산병원 소아청소년과) ;
  • 정희정 (국민건강보험공단 일산병원 소아청소년과)
  • Received : 2009.02.18
  • Accepted : 2009.03.27
  • Published : 2009.06.15
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Abstract

Herpes zoster is caused by the varicella-zoster virus (VZV), which affects nerve ganglions. VZV infection may be associated with neurologic complications, which are usually observed after vesicular exanthem. Acute aseptic meningitis is a rare complication of VZV reactivation. We report the case of a previously healthy 14-year-old boy who suffered from aseptic meningitis that was attributed to reactivated VZV infection with exanthem; the patient had undergone vaccination against varicella. This condition can be confirmed by the detection of VZV DNA in the cerebrospinal fluid. The patient was treated with acyclovir and recovered fully.

대상포진은 흔한 질환으로 여러 가지 합병증을 동반 할 수 있으나 대상포진에 동반되어 수막염이 생긴 경우는 보고는 많지 않다. 저자들은 15개월에 수두 예방접종을 시행 받았고, 5세 때 수두를 앓은 과거력이 있던 건강한 14세 남자 환아에서 대상포진에 동반되어 급성 무균성 수막염이 발생한 증례에서 뇌척수액에서 중합효소연쇄반응을 통해 VZV DNA를 검출한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

  1. Gershon AA. Varicella-zoster virus infections. Pediatr. Rev. 2008;29:5-11 https://doi.org/10.1542/pir.29-1-5
  2. Lee DK, Do JK, Kwak KH, Oh HJ. Three cases of acute aseptic meningitis followed by herpes zoster. J Korean Neurol Assoc 1996;14:1047-50
  3. Gilden DH, Kleinschmidt-DeMasters BK, LaGuardia JJ, Mahalingam R, Cohrs RJ. Neurologic complications of the reactivation of varicella-zoster virus. N Engl J Med 2000;342: 635-45 https://doi.org/10.1056/NEJM200003023420906
  4. Han KR, Kwak NK, Kim SM, Min KS, Kim C, Kim SM. Herpes zoster infection involved in cervical and thoracic spinal segment bilaterally. Korean J Pain 1999;12:144-7
  5. Lee DK, Kwak NK, Do JH, Oh HJ. Herpes zoster with multiple cranial and upper cervical nerves involvement. J Korean Neurol Assoc 1997;15:712-5
  6. Bjerkhoel A, Hyden D. Ramsay-Hunt syndrome in a preschool infant. ORL J Otorhinolaryngol Relat Spec 1989;51: 251-4 https://doi.org/10.1159/000276067
  7. Jhaveri R, Sankar R, Yazdani S, Cherry JD. Varicella-zoster virus: an overlooked cause of aseptic meningitis. Pediatric Infect Dis J 2003;22:96-7 https://doi.org/10.1097/00006454-200301000-00026
  8. Steiner I, Steiner-Birmanns B, Levin N, Hershko K, Korn- Lubertzki I, Biran I. Spinal cord involvement in uncomplicated herpes zoster. Clin Diagn Lab Immunol 2001;8:850-1
  9. Pui JC, Furth EE, Minda J, Montone KT. Demonstration of varicellar-zoster virus infection in the muscularis propria and myenteric plexi of the colon in an HIV-positive patient with herpes zoster and small bowel pseudo-obstruction (Ogilve's syndrome) Am J Gastroenteral 2001;96:1627-30 https://doi.org/10.1111/j.1572-0241.2001.03808.x
  10. Morch K, Fylkesnes SI, Haukenes G. Meningitis associated with reactivation of varicella zoster virus. Tidsskr Nor Laegeforen 2003;123:2871-3
  11. Ratzan KR. Viral meningitis. Med Clin North Am 1985;69: 399-413
  12. Kim Sk, Lee SH, Choi YC, Choi IS, Kim JH. Neurological complications of herpes zoster. J Korean Neurol Assoc 1994; 12:715-22 https://doi.org/10.1007/BF02337438
  13. Cohen JI, Brunell PA, Straus SE, Krause PR. Recent advances in varicella-zoster virus infection. Ann intern Med 1999;130:922-32
  14. Han DC, Park JH, Shin WC, Lee YB, Park HM, Shin DJ. A case of herpes zoster meningitis with involving multiple dermatomes. J Korean Geriatr Soc 2004;8:40-2
  15. Myers MG, Seward JF, LaRussa PS. Varicella-zoster virus. In : Behrman RE, Kliegman RM, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders, 2007;1366-72
  16. Kang JH, Jin YM, Roh EJ, Kang SY, Yu JS, Chung EH. Two cases of varicella zoster meningitis in immunocompetent children. Korean J Pediatr Infect Dis 2007;14:188-93
  17. Yeo JS, Sim WS, Kim YC. Herpes Sine Zoster : Is the cause for the segmental intercostal neuralgia of unknown cause? Korean J Pain 2005;18:226-8 https://doi.org/10.3344/kjp.2005.18.2.226
  18. Shin KW, Yang IA, Cho KS, Im SK, Lee SH. Clinical study of the prognosis of Ramsay-Hunt syndrome. Korean J Otolaryngol 1995;38:57-63
  19. Gross G, Schofer H, Wassilew S, Friese K, Timm A, Guthoff R, et al. Herpes zoster guideline of German Dermatology Society (DDG). J Clin Virol 2003;26:277-89 https://doi.org/10.1016/S1386-6532(03)00005-2
  20. Szinnai G, Farron F, Bar G, Heininger U. Herpes zoster and aseptic meningitis in a previously healthy child. Eur J Pediatr 2003;162:434-5
  21. Murakami S, Hato N, Horiuchi J, Honda N, Gyo K, Yanagihara N. Treatment of Ramsay Hunt syndrome with acyclovir-prednisone : significance of early diagnosis and treatment. Ann Neurol 1997;41:353-7 https://doi.org/10.1002/ana.410410310
  22. Kim SJ, Lee YS, Seo SR, Chun DK, Lee JR, Lee SC. Two cases of herpes zoster in healthy children after varicella vaccination. Korean J Dermatol 2001;39:250-2
  23. Matsubara K, Nigami H, Harigaya H, Baba K. Herpes zoster in a normal child after varicella vaccination. Acta Paediatr Jpn 1995;37:648-50 https://doi.org/10.1111/j.1442-200X.1995.tb03396.x

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