Varicella zoster virus infection presenting as isolated diplopia: a case report

• Published in: BMC infectious diseases Vol. 13; no. 1; p. 138
• Main Authors: Pisapia, Raffaella, Rianda, Alessia, Mariano, Andrea, Testa, Angela, Galgani, Simonetta, Vincenzi, Laura, Abdeddaim, Amina, Oliva, Alessandra, Narciso, Pasquale
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15-03-2013; BioMed Central
• Subjects: Adenoviruses; Adult; Anti-Inflammatory Agents - therapeutic use; Antigens; Antiviral agents; Antiviral Agents - therapeutic use; Care and treatment; Case Report; Chicken pox; Chickenpox; Corticosteroids; Cytomegalovirus; Diagnosis; Diagnosis, Differential; Diplopia; Diplopia - diagnosis; Encephalitis; Glucose; Guillain-Barre syndrome; Health aspects; Herpes viruses; Herpes Zoster - diagnosis; Herpes Zoster - drug therapy; Herpesvirus 3, Human - genetics; Herpesvirus 3, Human - isolation & purification; Humans; Infections; Infectious diseases; Male; Measles; Meningitis; Molecular Diagnostic Techniques; Nervous system; Neurological disorders; Patient outcomes; Shingles (Disease); Skin diseases; Steroids; Trochlear Nerve Diseases - diagnosis; Varicella-zoster virus; Virus diseases; West Nile virus; Rome Italy; Italy
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/1471-2334-13-138

Involvement of trochlear nerve during Varicella Zoster Virus (VZV) Infection has been rarely described, and always in association with skin rash.
We describe the case of a patient with VZV infection presenting as isolated diplopia due to fourth cranial nerve palsy. The diagnosis has been obtained through the application of a standardized molecular diagnostic panel, and diplopia resolved after specific antiviral and corticosteroid therapy.
This case evidences that clinicians should be aware of atypical VZV infection, even in the absence of the typical skin rash.