**5.1 Case 2: meningoencephalitis**

The patient was a 77-year-old woman who was admitted to our hospital due to convulsions and impaired consciousness. She presented with a Glasgow Coma Scale score of E1V1M4, and positive nuchal rigidity was observed. The convulsions were treated with the intravenous injection (IV) of diazepam and intramuscular injection of phenobarbital. However, the patient had high fever after admission at the hospital. CSF examination showed increased cell count (125.0 mg/dl), elevated protein level (125.0 mg/dl), and positivity for VZV DNA, and she was then diagnosed with VZV infection. The patient was treated with acyclovir and dexamethasone, and she regained consciousness and was able to talk on the second day of hospitalization. On the seventh day, she recovered with lucid consciousness without sequelae (**Figure 2**). Her MRI showed no abnormal lesions in the brain parenchyma, and she was diagnosed with meningoencephalitis.
