Meningitis without Rash after Reactivation of Varicella Vaccine Strain in a 12-Year-Old Immunocompetent Boy

• Published in: Vaccines (Basel) Vol. 11; no. 2; p. 309
• Main Authors: Bierbaum, Sibylle, Fischer, Veronika, Briedigkeit, Lutz, Werner, Claudius, Hengel, Hartmut, Huzly, Daniela
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.01.2023; MDPI
• Subjects: Acyclovir; Aseptic meningitis; Cerebrospinal fluid; Cerebrovascular disease; Chicken pox; Chickenpox vaccine; Children; Children & youth; Communication; Complications; Demographic aspects; Development and progression; DNA vaccines; Dosage and administration; Encephalitis; Enzymes; Exanthema; Genomes; Health aspects; Immunocompetence; Infections; Laboratories; Meningitis; Neurological complications; Skin; Vaccines; Varicella; varicella vaccine; varicella zoster virus; Viruses; zoster sine herpete; Germany; United States > US; varicella vaccine; varicella zoster virus; zoster sine herpete
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines11020309

Acute neurologic complications from Varicella-Zoster-Virus reactivation occur in both immunocompromised and immunocompetent patients. In this report, we describe a case of a previously healthy immunocompetent boy who had received two doses of varicella vaccine at 1 and 4 years. At the age of 12 he developed acute aseptic meningitis caused by vaccine-type varicella-zoster-virus without concomitant skin eruptions. VZV-vaccine strain DNA was detected in the cerebrospinal fluid. The patient made a full recovery after receiving intravenous acyclovir therapy. This disease course documents another case of a VZV vaccine-associated meningitis without development of a rash, i.e., a form of VZV infection manifesting as "zoster sine herpete".