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October 1981

CSF in Herpes Zoster Meningoencephalitis

Author Affiliations

From the Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Denver. Dr Reimer is now with the University of West Virginia Medical Center, Morgantown.

Arch Neurol. 1981;38(10):668. doi:10.1001/archneur.1981.00510100096020

The neurologic manifestations of herpes zoster varicella (HZV) infections have recently been reviewed.1 In previously reported cases, CSF values were normal to mildly altered. Protein values ranged from normal (in 50% of patients) to 400 mg/dL, and WBC counts ranged from 0 to 500 per microliter,2-4 with an isolated report of a case with 1,760 WBCs.5 Hypoglycorrhachia is unusual. We report the following case to show that CSF findings in HZV meningoencephalitis may be striking and may mimic those of acute pyogenic meningitis.

REPORT OF A CASE  A 78-year-old woman entered a rural hospital because of confusion and inappropriate behavior. She was in excellent health until one week earlier when ophthalmic HZ developed in the right eye. Laboratory studies of the CSF showed the following values: WBCs, 390/μL; protein, 284 mg/dL; and glucose, 13 mg/dL, with a plasma glucose level of 101 mg/dL. She was transferred

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