Meningitis aséptica por varicela zóster sin rash vesicular previo en paciente VIH positivo. Presentación de caso

The clinical presentation of aseptic meningitis in the context of an immunosuppressed patient with a diagnosis of Human Immunodeficiency Virus (HIV) infection, should lead us to consider multiple differential diagnoses. Among these, the Varicella Zoster Virus (VZV) has been found as one of the main causative agents of clear cerebrospinal fluid meningitis. Its reactivation gives rise to multiple life-threatening neurological manifestations in which vesicular rash, or papule / vesicular / crusted rash was considered a fundamental sign for its diagnosis. However, skin lesions are absent in more than a third of patients with central nervous system involvement. Herein, we report a case of an HIV-infected patient with headache, fever and  eutrophilic pleocytosis with FilmArray that confirms Varicella Zoster virus infection in an immunocompromised patient in the absence of vesicular rash. MED.UIS.2021;34(1): 91-9