Published online Oct 16, 2023. doi: 10.12998/wjcc.v11.i29.7101
Peer-review started: May 15, 2023
First decision: July 3, 2023
Revised: July 16, 2023
Accepted: August 3, 2023
Article in press: August 3, 2023
Published online: October 16, 2023
Processing time: 151 Days and 7.2 Hours
Varicella-zoster virus (VZV) is a common viral infection, but meningitis is a rare complication of VZV infection. The cerebrospinal fluid glucose of viral meningitis is usually within the normal range, which is different from bacteria, fungi, and cancerous meningitis. This paper reports a case of VZV meningitis with hypoglycorrhachia and the relevant literature was reviewed.
We report a case of an immunocompetent 39-year-old male, presenting with severe headache and fevers, without meningeal signs or exanthem, found to have VZV meningitis by the metagenomic next-generation sequencing of cerebrospinal fluid. The cerebrospinal fluid analysis revealed hypoglycorrhachia (cerebrospinal fluid glucose of 2.16) and he was treated successfully with intravenous acyclovir. Our literature review identified only ten cases diagnosed with VZV meningitis with hypoglycorrhachia previously reported to date in the English literature whose cerebrospinal fluid glucose was from 1.6 to 2.7mmol/L, with a ratio of cerebrospinal fluid to serum glucose from 0.30 to 0.49.
Although rare, the cerebrospinal fluid of patients with VZV meningitis may have hypoglycorrhachia, which broadens the understanding of the disease.
Core Tip: We report a case of an immunocompetent 39-year-old male, presenting with severe headache and fevers, found to have varicella-zoster virus (VZV) meningitis by the metagenomic next-generation sequencing of cerebrospinal fluid. The cerebrospinal fluid analysis revealed hypoglycorrhachia. Our literature review identified only ten cases diagnosed with VZV meningitis with hypoglycorrhachia previously reported whose cerebrospinal fluid glucose was from 1.6 to 2.7 mmol/L. Although rare, the cerebrospinal fluid of patients with VZV meningitis may have hypoglycorrhachia, which broadens the understanding of the disease.