A Case of Varicella-Zoster Virus Meningitis Presenting with Cluster Headache-Like Symptoms

Key Points

• This case describes a patient with varicella-zoster virus (VZV) meningitis presenting atypically with cluster headache symptoms.
• Clinical presentation of headache, ocular pain, and conjunctival injection was followed by treatment with sumatriptan and oxygen therapy.
• Cerebrospinal fluid analysis was performed on day three, detecting VZV-DNA.
• Observation of subsequent rash in the trigeminal region on day seven.
• Initial treatment for cluster headache was ineffective.
• VZV-DNA was detected in the cerebrospinal fluid at a concentration of 2.1 × 10^4 copies/mL.
• A rash appeared in the trigeminal area days after the headache onset, confirming the diagnosis.