CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1581803
Intrancranial hemorrhagic vasculitis in a child with varicella zoster virus infection: a case report
Provisionally accepted
Saket Satyasham Toshniwal1*
Jiwan Kinkar2Anand Loya3
Palash Sandeep Kotak1
Sourya Acharya1Anil Wanjari1- 1General Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, India
- 2Neurology, Datta Meghe Institute of Higher Education and Research, Wardha, India
- 3General Medicine, Padmashree Dr. D.Y. Patil University, Navi Mumbai, Maharashtra, India
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Background:Varicella Zoster Virus (VZV) infection is a frequent viral illness of childhood, usually manifesting as chickenpox and having a benign, self-limiting course. However, severe neurological complications, such as vasculitis resulting in intracranial hemorrhage, although uncommon, may occur and have considerable morbidity and mortality.Case Presentation:We present the case of a 7-year-old otherwise healthy male child who developed intracranial hemorrhagic vasculitis 14 days after a primary VZV infection. The child had sudden onset seizures and altered sensorium. Neuroimaging showed intracranial hemorrhage with evidence of cerebral vasculitis. Laboratory tests, cerebrospinal fluid (CSF) analysis, and serological studies confirmed recent VZV infection. The patient was treated with antiviral therapy and corticosteroids with gradual improvement.Discussion:This case illustrates a rare but severe vascular complication of VZV infection in children. The pathophysiology is viral-induced inflammation of the vessels, causing damage to the vessel wall, necrosis, and possible hemorrhage. Early detection by clinical suspicion, imaging, and CSF examination is essential for starting early treatment, which can change the course of the disease and improve outcomes.Conclusion:Intracranial hemorrhagic vasculitis is an uncommon but serious complication of VZV infection in children. This observation highlights the need to include post-infectious vasculitis in the differential diagnosis of any child with acute neurological presentation and a recent history of chickenpox, in order to avoid delay in diagnosis and management.
Keywords: Stroke, Child, vasculitic stroke, Vasculitis, Infection, varicella zoster virus
Received: 23 Feb 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Toshniwal, Kinkar, Loya, Kotak, Acharya and Wanjari. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Saket Satyasham Toshniwal, General Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, India
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