Background: Reactivation of varicella-zostervirus (VZV) can manifest as infection of the central nervous system. The detection of VZV DNA in cerebrospinal fluid by polymerase chain reaction has extended our knowledge about the frequency of various clinical manifestations in the immunocompetent host, also without the typical rash of shingles.
Material And Methods: Over a period of three years, 1999 through 2001, we performed VZV polymerase chain reaction in cerebrospinal fluid in 364 patients with suspected infection of the central nervous system.
Results: We detected VZV DNA in the cerebrospinal fluid in five patients. Four of the patients had reactivated VZV infection. Meningitis was seen in two young immunocompetent individuals; one of them without shingles. One patient had myelitis without shingles and one had zoster radiculitis. One patient was a child with encephalitis and primary infection.
Interpretation: Our results are similar to results from other investigators that have found VZV DNA in the cerebrospinal fluid in immunocompetent patients with meningitis or encephalitis as the most common clinical manifestation, with or without shingles.
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