2020 Volume 33 Issue 2 Pages 111-117
The varicella-zoster virus （VZV） can cause meningitis and lead to multiple central nerve involvement. A 69-year-old man complaining of sore throat and progressively worsening difficulty with oral intake for 6 days was referred to our hospital with a diagnosis of varicella zoster pharyngitis. A physical examination identified vesicular eruptions on the left auricle, external ear canal, and left side of the oropharynx, accompanied by scattered vesicles throughout his body surface. However, there was no evidence of cranial nerve involvement. Therefore, he was hospitalized in a depressurized room, and 1,500mg of Acicrobil was administered per day. By day 6 of hospitalization, most of the vesicles had scabbed over, but left vocal cord palsy manifested. On day 7 to 10 of hospitalization, palsy of cranial nerves Ⅶ, Ⅸ, Ⅹ, and Ⅺ appeared. The results of cerebrospinal fluid examination suggested that the patient suffered from VZV meningoencephalitis. Therefore, additional Acicrobil and Methylprednisolone therapy was administered. On day 41 of hospitalization, the patient was discharged on foot. However, paralysis of the left side of his facial nerve and accessory nerve remained.
