This paper describes the case of a patient with a history of affective disorder who developed encephalitis associated with herpes zoster which presented as a delirium with prominent manic symptoms. Published reports of encephalitis following herpes zoster infections are reviewed. The diagnosis of herpes zoster-associated encephalitis should be suspected in individuals with changes in his or her mental state, an abnormal electroencephalogram and an abnormal cerebrospinal fluid examination which closely follow a cutaneous herpes zoster lesion.
References
1.
FolsteinMF, FolsteinSE, McHughPR. “Mini-mental state”. A practical method of grading the cognitive state for the clinician. J Psychiatr Res1975; 12: 189–198.
JemsekJ, GreenbergSB, TaberL, Herpes zoster-associated encephalitis: clinicopathologic report of 12 cases and review of the literature. Medicine198362: 81–97.
4.
BarnesDW, WhitleyRJ. CNS diseases associated with varicella zoster virus and herpes simplex virus infection. Neurol Clin1986; 4: 265–283.
5.
BucciFA, SchwartzRA. Neurologic complications of herpes zoster. Am Fam Physician1988; 37: 185–192.
6.
JohnsDR, GressDR. Rapid response to acyclovir in herpes zoster-associated encephalitis. Am J Med1987; 82: 560–562.
7.
SteeleRW, KeeneyRE, BradsherRW, Treatment of varicella-zoster meningoencephalitis with acyclovir—demonstration of virus in cerebrospinal fluid by electron microscopy. Am J Clin Pathol1983; 80: 57–60.
8.
BellL.On a form of disease resembling some advanced stages of mania and fever, but so contradistinguished from any ordinarily observed or described combination of symptoms as to render it probable that it may be an overlooked and hitherto unrecorded malady. Am J Insanity1849; 6: 97–127.
9.
GoodwinFK, JamisonKR. Clinical description and diagnosis. In: Manic-depressive illness.Oxford: Oxford University Press, 1990: 24–25.
10.
EvansAT, CroftSL, PetersW, Hydrazide antidepressants possess novel antileishmanial activity in vitro and in vivo. Ann Trop Med Parisitol1989; 83: 19–24.
