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CASE REPORT
Herpes zoster encephalopathy or acyclovir neurotoxicity: a management dilemma
  1. Daniel Sacchetti1,
  2. Aydah Alawadhi1,
  3. Mustafa Albakour2,
  4. Alwyn Rapose3
  1. 1Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA
  2. 2Department of Internal Medicine, Reliant Medical Group, Worcester, Massachusetts, USA
  3. 3Department of Infectious Diseases, Reliant Medical Group and Saint Vincent Hospital, Worcester, Massachusetts, USA
  1. Correspondence to Dr Alwyn Rapose, alwyn.rapose{at}gmail.com

Summary

This is a case report of a 69-year-old morbidly obese woman who presented with mental status changes after she was treated with acyclovir for shingles. The predominant symptoms were word-finding difficulties and visual hallucinations. Complicating her presentation was acyclovir-induced acute renal injury causing her creatinine level to rise up to 7.4 mg/dL. Acyclovir was discontinued on the suspicion of acyclovir neurotoxicity. Even though PCR for varicella zoster virus in the cerebrospinal fluid was positive, acyclovir was not restarted and the patient continued to improve and returned to her baseline.

https://doi.org/10.1136/bcr-2013-201941

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