Abstract
Background
Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a clinical-imaging syndrome involving the splenium of the corpus callosum(SCC) that is relatively rare and diverse in its clinical manifestations. The most common pathogens are influenza A and B viruses, as well as rotavirus, measles virus, adenovirus, streptococcus, and Escherichia coli. MERS caused by Mycoplasma pneumoniae, Leptospira, and cerebral malaria infections is relatively rare, and there has been no research on herpes zoster virus causing MERS.
Case description
A Chinese young man was hospitalized in the emergency department due to mental and behavioral changes on the fourth day after fever. The patient's cerebrospinal fluid metagenomic next-generation sequencing (mNGS) results showed positive for varicella zoster virus (VZV). Magnetic resonance imaging (MRI) revealed a lesion with restricted diffusion in the corpus callosum. He did not show any skin blisters. He neurological symptoms resolved after 2 days, and after 4 weeks, the brain lesion was not detected on MRI.
Conclusion
The varicella zoster virus can cause MERS, with clinical manifestations mainly including headache, irritability, and other mental and behavioral abnormalities. Patients may not have the skin manifestations of varicella zoster.