A Clinical and Laboratory Comparison of Varicella-Zoster Virus (VZV) and Epstein-Barr Virus (EBV): Two Cases of Herpesvirus Meningitis in Immunocompetent Adults and a Literature Review.

Authors

Israa A Serhal, Sara Najib, Ibrahim Serhal, Ghenwa K El Dakdoukii

Published in

Cureus. Volume 18. Issue 8. Pages e114529. Epub Aug 14, 2026.

Abstract

Varicella-zoster virus (VZV) and Epstein-Barr virus (EBV) are uncommon causes of aseptic meningitis in immunocompetent individuals. We report two cases of polymerase chain reaction (PCR)-confirmed viral meningitis caused by VZV and EBV in previously healthy young adults and compare their clinical presentation, cerebrospinal fluid (CSF) findings, neuroimaging, treatment response, and outcomes with previously reported cases. Both patients presented with lymphocytic meningitis and normal neuroimaging findings. The patient with VZV meningitis experienced rapid clinical improvement following acyclovir therapy and developed a vesicular rash two days after symptom onset, whereas the patient with EBV meningitis presented with a broader range of systemic and neurological symptoms and showed a more gradual recovery. Despite a shared lymphocytic CSF pattern, the two cases demonstrated distinct clinical and laboratory profiles. These findings highlight the importance of molecular testing for definitive diagnosis and support consideration of both viruses in the differential diagnosis of aseptic meningitis in immunocompetent patients.

PMID:
42733768
Bibliographic data and abstract were imported from PubMed on 14 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.