CASE REPORT article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1631412
Varicella-Zoster Virus Infection in Pregnancy: A Case of Aseptic Meningitis Before 20 Weeks Gestation and review of the Literature
Provisionally accepted
- Puer People's Hospital, Yunnan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Varicella zoster virus (VZV) infection during pregnancy can lead to severe complications. However, cases complicated by aseptic meningitis in early pregnancy (<20 weeks) are extremely rare, and clinical management and pregnancy outcomes remain unclear.Case Report: We report a case of a 36-year-old pregnant woman who developed right upper abdominal pain, headache, and cough at 17 weeks of gestation, followed by clustered herpes zoster lesions in the right lumbar region and signs of meningeal irritation. Aseptic meningitis was confirmed by cerebrospinal fluid analysis (lymphocytes 184×10⁶/L, protein 938 mg/L), and other etiologies were excluded by imaging. A 14-day course of acyclovir (5 mg/kg q8h) combined with prednisone achieved complete symptom resolution through a multidisciplinary collaboration (neurology, obstetrics, infectious diseases, pharmacy, and nursing). The patient experienced unexplained preterm delivery at 35 weeks, delivering a healthy male infant (2680 g, Apgar 9-10-10) via cesarean section, with no sequelae at the 1-year follow-up.Conclusion: This represents the fourth reported case of VZV meningitis during pregnancy globally and the first occurring before 20 weeks of gestation with preterm delivery as a unique outcome. Key implications: (1)Early-to-mid gestation VZV infection may affect pregnancy outcomes through distinct mechanisms; (2) multidisciplinary management is critical for optimizing maternal-fetal prognosis; and (3) further investigation is needed to elucidate the relationship between infection timing and preterm birth.
Keywords: varicella-zoster virus, Pregnancy, Aseptic meningitis, Antiviral therapy, multidisciplinary management, preterm delivery
Received: 19 May 2025; Accepted: 29 Jul 2025.
Copyright: © 2025 Song, qun, Yang, Li, Zhang and Chen. 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:
Gao Song, Puer People's Hospital, Yunnan, China
Si-Wei Chen, Puer People's Hospital, Yunnan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.