Resumen
Un cuadro de meningitis aséptica, en el contexto de un paciente inmunosuprimido con diagnóstico de infección por Virus de Inmunodeficiencia Humana (VIH), debe llevar a pensar en múltiples diagnósticos diferenciales. Entre estos, se incluye el virus varicela zóster (VVZ) como uno de los principales agentes causales de meningitis a líquido cefalorraquídeo claro. Su reactivación da lugar a múltiples manifestaciones neurológicas potencialmente mortales en las que se consideraba al rash vesicular, o exantema pápulo/vesículo/ costroso como un signo fundamental para su diagnóstico. No obstante, las lesiones cutáneas están ausentes en más de un tercio de los pacientes con compromiso del sistema nervioso central. A continuación, se presenta el caso de un paciente con infección por VIH que presenta cefalea más fiebre, con hallazgos en líquido cefalorraquídeo de pleocitosis neutrofílica y una prueba molecular confirmatoria para virus varicela zóster, en ausencia de rash vesicular previo que guiara hacia este diagnóstico. MÉD.UIS.2021;34(1): 91-9.
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