Disseminated herpes zoster with acute encephalitis in an elderly man: a case report

Introduction:Disseminated herpes zoster is uncommon and typically occurs in immunocompromised populations such as in patients with HIV/AIDS, transplantation, and autoimmune disease. However, it can also occur in healthy hosts. Central nervous system complications during or after herpes zoster outbreaks are extremely rare. Encephalitis has been reported to affect only 0.1% ~ 0.2% of patients. The occurrence of disseminated herpes zoster combined with acute encephalitis in immunocompetent patients is less frequently reported. Case presentation:An 85-year-old male presented with disseminated herpes zoster and acute encephalopathy, later confirmed as VZV encephalitis via CSF analysis and neuroimaging. Treatment with IV acyclovir and methylprednisolone led to gradual improvement in consciousness and skin lesion regression, though dizziness persisted. Conclusion:Patients with disseminated herpes zoster should be closely monitored for potential complications such as herpes zoster encephalitis.