Varicella Zoster Virus Causing Aseptic Meningitis Without Fever or Rash in an Immunocompetent Patient

Varicella-Zoster Virus (VZV) is known to be a cause of aseptic meningitis and can be potentially fatal. VZV meningitis can arise in immunodeficient and more rarely, immunocompetent hosts. We present here a rare case of VZV causing meningitis in a 44-year-old immunocompetent man. He presented with an isolated headache without any fever or rash. CSF PCR for VZV DNA was positive confirming VZV as the cause of meningitis. He was treated with IV ganciclovir for 3 days and was transitioned to oral valacyclovir to complete a total of 10 days of antiviral treatment with the resolution of the headache. The purpose of this case report is to highlight VZV as a cause of aseptic meningitis in immunocompetent individuals and emphasize the importance of using airborne precautions along with contact precautions in health care workers who deal with patients with VZV shingles.