Halil ÖZDEMİR, Göksel VATANSEVER, Ülker DOĞRU, Gül KAZANCI, Adem KARBUZ, Erdal İNCE, Ergin ÇİFTÇİ

Zona zoster enfeksiyonu sırasında gelişen aseptik menenjit

Zona zoster, immün sistemi sağlam olan çocuklarda sıklıkla iyi seyirli bir hastalıktır. İmmün sistemi baskılanmış hastalarda ise yaygın olma riski taşır. Zona zoster, hem immün sistemi sağlam, hem de immün sistemi baskılanmış çocuklarda nadiren miyelit, aseptik menenjit, ansefalit ve ventrikülit gibi nörolojik komplikasyonlara yol açabilir. On yedi yaşında talasemi major nedeniyle kemik iliği transplantasyonu yapılmış olan kız hasta, ateş, sağ göğüs ön yüzü ve koltuk altında kaşıntılı döküntüler ile hastanemize başvurdu. Hastaya klinik olarak zona zoster tanısı konuldu. İzlemde şiddetli başağrısı ve kusmaları oldu. Hastada ense sertliği ve meninks iritasyon bulguları saptandı ve lomber ponksiyon yapıldı. Beyin omurilik sıvısında pleositoz ve protein yüksekliği görüldü. Beyin omurilik sıvısında VZV-PCR pozitif saptanması üzerine zona zostere bağlı aseptik menenjit tanısı doğrulandı. On gün asiklovir verilen hasta sekelsiz olarak iyileşti. Zona zoster gelişen immün sistemi baskılanmış çocuklarda başağrısı ve kusma gibi belirtiler ortaya çıkarsa aseptik menenjit gibi nörolojik komplikasyonların gelişebileceği akılda tutulmalıdır.

Aseptic meningitis due to zona zoster infection

Zona Zoster, is a mostly benign disease in immunocompetent children. Those of in immunocompromised children, there is a risk of dissemination. Zona zoster, scarcely causes some neurological complications such as myelitis, aseptic meningitis, encephalitis and ventriculitis in both immunocompetent and immunocompromised children. A 17-year-old girl who had bone marrow transplantation for thalasemia major was admitted to our hospital with fever, itchy rash on the right chest and axillary region and diagnosed as zona zoster. She had severe headache and vomiting on follow-up. We performed lumbar puncture because of the neck stiffness and meningeal irritation signs, pleocytosis and protein elevation were detected in the cerebrospinal fluid (CSF). The diagnosis of aseptic meningitis due to zona zoster was confirmed by VZV-PCR in the CSF. She cured without sequele after the administration of acyclovir treatment for 10 days. If symptoms such as headache and vomiting develop in immunocompromised children with zona zoster, neurological complications like aseptic meningitis should be remembered.

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