Chronic varicella-zoster-virus encephalitis in an elderly patient

A 67-year-old woman presented with acute confusional episodes with a background of progressive, mental deterioration and seizures. Antibodies to varicella-zoster-virus were found in the cerebrospinal fluid. Brain biopsy was performed 17 months following the onset of illness and the histopathological examination of brain tissue showed selective neuronal injury and reactive gliosis. This case suggests that varicella-zoster-virus is a possible causative agent of chronic encephalitis in immunocompetent patients and stresses the importance of therapy with acyclovir.