Herpes-zoster (Varicella zoster) infection

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Background  Histopathology & Immunohistochemistry

BACKGROUND AND CLINICAL INFORMATION: Head

Summary: The agent is varicella-zoster virus. Herpes-zoster most often occur as a ganglionitis. It causes encephalitis in only rare occasions.

Anatomic locations:

• Dorsal root ganglions.

• The trigerminal nerve (especially the ophthalmic division) or the 3rd to 10th thoracic spinal ganglion are most commonly involved.

HISTOPATHOLOGY AND IMMUNOHISTOCHEMISTRY: Head

Latent viral particles reside in non-neuronal cells. Neuronal necrosis and inflammatory cell infiltration in the sensory ganglion. The spinal cord or pons adjacent to the infected ganglions may also be affected.

A herpes zoster encephalitis has also been described. The infected cells contain nuclear (Cowdry Type A) and intracytoplasmic inclusion bodies. They may also have vasculopathy and may be associated with multiple infarcts.