Zona zoster associated with aseptic menengitis and hepatitis in two immunocompetent cases after emotional stress

Zona zoster is a mostly benign disease in immunocompetent individuals. On the other hand among immunocompomised persons, there is a risk of dissemination. Zona Zoster causes some neurological complications such as myelitis, aseptic meningitis, encephalitis and ventriculitis in both immunocompetent and immunocompromised individuals. Two (Twenty and twenty two-year old) immunocompetent patients were admitted to emergency service at different time with the similar complaints with fever, severe headache, vomiting and somnolans. In addition one of them had a walking and balance problem. Neck stiffness and meningeal irritation signs were found in both of them. Then we performed a lumbar puncture. Pleocytosis and protein elevation were detected in cerebrospinal fluid (CSF) samples, respectively. After hospitalization both of their histories were the same, having intense emotional stress before the symptoms had occured. We diagnosed zona zoster with complications from aseptic meningitis according to the clinical findings and positive of serum VZV IgM by ELISA. They cured without sequele after the administration of acyclovir. For patients with zona zoster who have not got immune deficiency but are under severe emotional stress,the risk of central nervous system complications should be kept in mind