Zoster sine herpete: Detection by skin exudates and contrast magnetic resonance imaging

摘要

A 44-year-old man presented with a progressive hoarseness, dysphagia, nasopharyngeal reflux, and right ear pain without eruption. Neurological examination revealed peripheral palsies of the cranial nerves VII-XI. The cerebrospinal fluid (CSF) contained 36.7 mononuclear cells/mm~3. Polymerase chain reaction (PCR) detected varicella zoster virus (VZV) DNA in right auricular skin exudates, but not in CSF. Magnetic resonance imaging with contrast revealed enhanced lesions in the right cranial nerves VII-XI (fig. 1a-c).