A Case Report of Varicella Zoster Meningitis as Co-Infection With Breakthrough COVID-19 in an Immunocompetent Patient
- Author:
SeungHoon YUN
1
;
Jinyong KIM
;
Hye-Rim SHIN
Author Information
- Publication Type:Case Report
- From:Journal of Korean Medical Science 2022;37(8):e61-
- CountryRepublic of Korea
- Language:English
- Abstract: There are several previous reports that infection or reactivation of varicella zoster virus (VZV) can occur after coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Herein, we report a rare case of VZV meningitis in breakthrough COVID-19. An 18-years-old male visited the emergency room, presenting with a headache and fever of up to 38.4°C for 5 days. He received the second dose of BNT162b2 mRNA SARS-CoV-2 vaccine 7 weeks prior to symptom onset. The symptoms persisted with headache, fever, and nausea. His cerebrospinal fluid (CSF) showed an elevated opening pressure of 27 cm H2O, 6/µL red blood cells, 234/µL white blood cells polymorphonuclear leukocytes 3%, lymphocytes 83%, and other 14%), 43.9 mg/dL protein, and 59 mg/dL glucose, and CSF polymerase chain reaction (PCR) test was positive for VZV. Also, he was diagnosed with COVID-19 by reverse transcriptase-PCR examining upper and lower respiratory tract. We administered intravenous acyclovir for 12 days, and he was discharged without any neurologic complication.