Brief Communication Severe Meningoencephalitis Due to Late Reactivation of Varicella-Zoster Virus in

Recurrent reactivation of latent Varicella-Zoster virus may cause various neurological complications including encephali-tis, myelitis, stroke episodes, and meningitis. It occurs mainly in elderly or immunocompromised patients and is very rare in children. We report a 14-year girl who presented with menin-goencephalitis due to reactivation of Varicella-Zoster virus 10 years after she had chickenpox and 4 years after she had zoster. Characteristic skin lesions of varicella were absent. Varicella-Zoster virus DNAwas detected in cerebrospinal fluid and magnetic resonance imaging (MRI) findings were consis-tent with small vessel cerebral vasculitis. Treatment with acyclovir and high dose methylprednisolone resulted in near-complete neurological recovery. Although rare, Varicella-Zoster virus may reactivate to cause significant central nervous system disease even in immunocompetent children. Diagnosis depends on a high degree of suspicion because the typical rash may not associate the disease. Characteristic lesions on MRI and the presence of Varicella-Zoster virus DNA in cerebrosp-inal fluid are key findings for the correct diagnosis