Cao LJ, Zheng YM, Li F, Hao HJ, Gao F. Varicella-zoster virus meningitis with hypoglycorrhachia: A case report. World J Clin Cases 2023; 11(29): 7101-7106 [PMID: 37946771 DOI: 10.12998/wjcc.v11.i29.7101]
Corresponding Author of This Article
Yi-Ming Zheng, MD, Doctor, Department of Neurology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China. 804067836@qq.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2023; 11(29): 7101-7106 Published online Oct 16, 2023. doi: 10.12998/wjcc.v11.i29.7101
Varicella-zoster virus meningitis with hypoglycorrhachia: A case report
Li-Juan Cao, Yi-Ming Zheng, Fan Li, Hong-Jun Hao, Feng Gao
Li-Juan Cao, Yi-Ming Zheng, Fan Li, Hong-Jun Hao, Feng Gao, Department of Neurology, Peking University First Hospital, Beijing 100034, China
Li-Juan Cao, Department Acupuncture and Moxibustion, Huguosi Traditional Chinese Medicine Hospital Attached to Beijing Traditional Chinese Medicine University, Beijing 100034, China
Author contributions: Cao LJ and Zheng YM contributed to the drafting, and reporting of the case; Li F and Hao HJ contributed to revision of the manuscript; Gao F contributed to the concept and revision of the manuscript; and all authors read and approved the final manuscript, and met the authorship criteria from the International Committee of Medical Journal Editors; Zheng YM and Gao F are the co-corresponding authors of this manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Ming Zheng, MD, Doctor, Department of Neurology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100034, China. 804067836@qq.com
Received: May 15, 2023 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
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
