J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website https://jnr.elmerpub.com

Case Report

Volume 16, Number 1, March 2026, pages 40-44

New-Onset Human Immunodeficiency Virus Presenting as Varicella Zoster Reactivation With Central and Peripheral Nervous System Manifestations: Report of Two Cases

Figures

↓ Figure 1. Vesicular rash of case 2 extending from above the knee downwards in an L4 dermatome distribution.

↓ Figure 2. Pre-contrast T1-weighted sagittal images of the L-spine (left) and post-contrast (right) with enhancement of cauda equina nerve roots.

Tables

↓ **Table 1.** Pertinent Serum Studies From Cases 1 and 2
Lab (range)	B12	ESR (0–15)	CRP (0–0.5)	CPK (29–168)	HIV Ab 1	HIV Ab 2	HIV PCR (< 30 copies/mL)	CD4 count	Trep Ab	HSV PCR blood	Vesicle scraping VZV PCR
CPK: creatine phosphokinase; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; HIV PCR: human immunodeficiency virus polymerase chain reaction; Trep Ab: treponema antibody; VZV: varicella-zoster virus.
Case 1	254	73	0.06		+	–	311,458	11	–
Case 2		28	0.21	51	+	–	79,388	209	–	–	+

↓ **Table 2.** Pertinent CSF Findings From Case 1 With Reference Ranges
	CSF NUCS	CSF PROTEIN	CSF GLUCOSE	CSF VZV DNA	CSF CYTOLOGY	CSF OCB	CSF IGG	CSF MBP
Case 2 declined LP. CSF: cerebrospinal fluid; LP: lumbar puncture; MBP: myelin basic protein; NUCS: nucleated cells; OCB: oligoclonal bands; VZV: varicella-zoster virus.
RANGE	0–4	15–45	40–70				0–4.5	0–6
CASE 1	51	77	66	+	–	–	10.35	11.8