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Cureus. 2017 Sep 16;9(9):e1693. doi: 10.7759/cureus.1693.

A Unique Case of Acute Cerebral Venous Sinus Thrombosis Secondary to Primary Varicella Zoster Virus Infection.

Author information

1
Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan.
2
Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan.
3
Medicine, Shifa International Hospital, Islamabad, Pakistan.
4
Department of Neurology, Shifa International Hospital, Islamabad, Pakistan.

Abstract

Primary varicella zoster virus (VZV) infection, predominantly in the pediatric population, presents with pyrexia and a classic pruritic vesicular rash. In adults, although less common, it is more severe and linked to more complications. Neurological complications, which account for less than 1% of all VZV complications, include meningitis, encephalitis, arterial vasculopathy, and venous thrombosis. We present a case of a 39-year-old male who developed extensive cerebral venous sinus thrombosis following primary VZV infection. Venous thrombosis in VZV has been suggested to be caused by autoantibodies against protein S, pre-existing hypercoagulability, or endothelial damage. The patient was acutely managed using intravenous acyclovir and heparin. Long-term anticoagulation therapy with warfarin was continued after discharge. We concluded that clinicians should be aware of the rare complications of this common pathology so that a timely diagnosis can be made, followed by prompt management. Further studies need to be done to better understand acute cerebral venous sinus thrombosis secondary to VZV.

KEYWORDS:

cerebral venous thrombosis; chickenpox; cvst; cvt; varicella; venous thrombosis; vzv

Conflict of interest statement

The authors have declared that no competing interests exist.

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