Background: Primary infection (chickenpox) or infection after reactivation (herpes zoster) of the herpesvirus Varicella-Zoster Virus (VZV) can lead to central nervous system complications, such as meningoencephalitis. This study aimed to determine the frequency of VZV infections in patients with meningoencephalitis.

Methods: The serum and Cerebrospinal Fluid (CSF) sample data of 336 patients with meningoencephalitis, collected from the Health Surveillance Network, were analyzed. Immunoglobulin M (IgM) antibodies were detected in serum samples using Enzyme Immunoassay (EIA), and the CSF samples were used for molecular identification of VZV DNA via Polymerase Chain Reaction (PCR) using VM20 and VP22 primers.

Results: Because of the lack of paired serum and CSF samples from all patients, samples from 101, 229, and 6 patients were tested using both PCR and EIA, only PCR, and only EIA, respectively. Among the paired and unpaired serum samples, 4.67% (5/107) were VZV-positive. Among these, 40% (2/5) and 60% (3/5) were obtained from male and female patients, respectively, belonging to different age groups ranging 6-66 years. Among the paired and unpaired CSF samples, 0.90% (3/330) were VZV-positive by PCR. Among these, one (33.4%) sample was obtained from a patient aged 10-19 years, while two (66.6%) samples were obtained from patients aged 0-10 years, of which one patient was male. The most frequent symptoms were dysphagia, headache, epileptic seizures, tremors, and cervical weakness. Muscle weakness was reported in all patients.

Conclusions: Given the symptoms severity of the VZV, a rapid diagnosis is essentially needed to prevent mortality rate at all ages.