Herpes Zoster Meningitis Complicating Combined Tocilizumab and Cyclosporine Therapy for Adult-Onset Still’s Disease

الملخص EN

A 56-year-old female with refractory adult-onset Still’s disease presented with ocular herpes zoster infection during TCZ treatment.

After three days of acyclovir treatment (5 mg/kg), she developed a severe headache and high fever.

Viral DNA isolation and cerebral spinal fluid abnormalities led to a herpes zoster meningitis diagnosis.

Her meningitis was cured by high doses of intravenous acyclovir (10 mg/kg for 14 days).

To our knowledge, this is the first report of meningeal herpes zoster infection in rheumatic diseases under TCZ treatment.