Abstract
A 41-year-old man with herpes zoster on his forehead, the area of the first branch of the trigeminal nerve, was hospitalized and treated with 750 mg/day acyclovir. On the 2nd day of hospitalization, high fever, headache, vertigo, nausea and nystagmus developed. Lymphocyte count was markedly increased and VZV-DNA was detected by PCR in his cerebrospinal fluid. Based on these cerebrospinal fluid findings and manifestations, the diagnosis of VZV-associated meningoencephalitis was made. The dose of acyclovir was tripled (2250 mg/day), and steroid pulse therapy with 500 mg methylprednisolone was added. His cutaneous and central nervous system symptoms disappeared in 2 days, and no relapse occurred thereafter. Our experience suggests that dermatologists should consider central nervous system complications in patients with herpes zoster, even in young patients without underlying disorders.
