JCNRJournal of Clinical and Nursing Research2208-36852208-3693Bio-Byword Scientific Publishing Pty. Ltd.10.26689/jcnr.v8i9.7928ArticleVaricella-Zoster Virus Encephalitis with Hyponatremia in an Immunocompetent Elderly Patient: A Case Reporthttps://artdesignp.com/journal/JCNR/8/9/10.26689/jcnr.v8i9.7928YangLuxuan,ZhangWenyong,ShenXiujuan,LiuMeiqin,XiaoDan2024892024-09-26As a common cause of viral encephalitis, varicella-zoster virus (VZV) may invade the central nervous system of immunosuppressed patients during reactivation. Herein, we report a rare case of an immunocompetent patient with VZV encephalitis who developed severe hyponatremia and was considered to have a suspected primary infection. The patient was diagnosed with the support of second-generation sequencing and had persistent hyponatremia after being cured. Although rare, this case suggests that VZV encephalitis may occur in unexpected patients and present with unusual clinical manifestations, requiring advanced detection methods and clinical expertise for resolution.

Nagel MA, Niemeyer CS, Bubak AN, 2020, Central Nervous System Infections Produced by Varicella-Zoster Virus. Curr Opin Infect Dis, 33(3): 273–278.

Alvarez JC, Alvarez J, Tinoco J, et al., 2020, Varicella-Zoster Virus Meningitis and Encephalitis: An Understated Cause of Central Nervous System Infections. Cureus, 12(11): e11583.

Matthews E, Beckham JD, Piquet AL, et al., 2022, Herpesvirus-Associated Encephalitis: an Update. Curr Trop Med Rep, 9(3): 92–100.

Abbas SA, El Helou J, Chalah MA, et al., 2019, Longitudinal Extensive Transverse Myelitis in an Immunocompetent Older Individual: A Rare Complication of Varicella-Zoster Virus Reactivation. Medicina (Kaunas), 55(5): 201.

Oh JH, Tummala S, Husnain MG, 2020, Disseminated Herpes Zoster with Acute Encephalitis in an Immunocompetent Elderly Man. BMJ Case Rep, 13(6): e232928.

Tecellioglu M, Kamisli S, Erbay MF, et al., 2017, A Rare Presentation of Cranial Polyneuropathy Without Rash Caused by Varicella-Zoster Virus. Med Arch, 71(4): 293–295.

Takahashi T, Tamura M, Miki K, et al., 2013, Varicella-Zoster Virus Myelitis in Two Elderly Patients: Diagnostic Value of Nested Polymerase Chain Reaction Assay and Antibody Index for Cerebrospinal Fluid Specimens. Case Rep Neurol, 5(1): 81–90.

Lynch K, Agarwal P, Paranandi A, et al., 2014, Extensive VZV Encephalomyelitis without Rash in an Elderly Man. Case Rep Neurol Med, (2014): 694750.

Wang CC, Shiang JC, Chen JT, et al., 2011, Syndrome of Inappropriate Secretion of Antidiuretic Hormone Associated with Localized Herpes Zoster Ophthalmicus. J Gen Intern Med, 26(2): 216–220.

Foppiani L, 2018, SIADH with Severe Hyponatremia in an Elderly Man with Herpes Zoster Infection: A Causal or Casual Association? Intern Med, 57(23): 3393–3398.

Bassi V, Fattoruso O, Santinelli C, 2017, Localized Herpes Zoster Infection: A Rare Cause of Syndrome of Inappropriate Secretion of Antidiuretic Hormone. Oxf Med Case Reports, 2017(11): omx065.

Vinzio S, Lioure B, Enescu I, et al., 2005, Severe Abdominal Pain and Inappropriate Antidiuretic Hormone Secretion Preceding Varicella-Zoster Virus Reactivation 10 Months After Autologous Stem Cell Transplantation for Acute Myeloid Leukaemia. Bone Marrow Transplant, 35(5): 525–527.

Szabó F, Horvath N, Seimon S, et al., 2000, Inappropriate Antidiuretic Hormone Secretion, Abdominal Pain and Disseminated Varicella-Zoster Virus Infection: An Unusual Triad in a Patient 6 Months Post Mini-Allogeneic Peripheral Stem Cell Transplant for Chronic Myeloid Leukemia. Bone Marrow Transplant, 26(2): 231–233.

Braude MR, Trubiano JA, Heriot A, et al., 2016, Disseminated Visceral Varicella-Zoster Virus Presenting with the Constellation of Colonic Pseudo-Obstruction, Acalculous Cholecystitis and Syndrome of Inappropriate ADH Secretion. Intern Med J, 46(2): 238–239.

Lubomski M, Brown L, Markus R, 2017, An Unusual Presentation of Varicella-Zoster Virus with Acute Cerebellitis and SIADH Without a Rash. J Clin Neurosci, (41): 90–91.