RT Journal Article SR Electronic T1 Disseminated herpes zoster with acute encephalitis in an immunocompetent elderly man JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e232928 DO 10.1136/bcr-2019-232928 VO 13 IS 6 A1 Oh, Jessica Hyejin A1 Tummala, Saketh A1 Husnain, Muhammad Ghazanfar YR 2020 UL http://casereports.bmj.com/content/13/6/e232928.abstract AB Varicella-zoster virus (VZV) encephalitis typically occurs in immunosuppressed populations such as in patients with HIV/AIDS, transplantation and autoimmune disease. However, it can also occur in healthy hosts. We present the case of an immunocompetent patient who presented with a clinical picture of VZV encephalitis with the sole precipitating factor of advanced age. We want to stress the importance of including VZV in the differential diagnosis for encephalitis in healthy elderly hosts. In patients with a clinical diagnosis of encephalitis, the presence of herpes zoster rash increases the likelihood of VZV encephalitis. However, the absence of a skin rash may not exclude the diagnosis. In general, there is an elevated risk of transient ischaemic attack and stroke associated with the diagnosis of herpes zoster infection. Early treatment is essential to prevent complications, including death.