Pre-eruptive varicella encephalitis: Case report and review of the literature

Varicella-related neurological complications usually appear after the rash. Pre-eruptive neurological complications of primary varicella zoster virus infections have been rarely described. We report on a 5.5-year-old boy who developed encephalitis 4 days before the onset of a mild vesicular skin rash and 5 days after known exposure. Primary varicella zoster virus infection was confirmed serologically. Cranial magnetic resonance imaging revealed temporary inflammatory oedema in the right cerebellar peduncle. Conclusion: Neurological complications of varicella may appear up to 2.5 weeks before the onset of the exanthema. Physicians treating patients with ataxia or encephalitis should inquire about exposure to varicella zoster virus.