Background: Varicella-zoster virus (VZV) infection can be diagnosed clinically once classical rash occurs but the\ndiagnosis is challenging when typical rash is absent. We reported a case of fulminant central nervous system (CNS)\nVZV infection in a human immunodeficiency virus (HIV)-infected patient without typical VZV-related rash. CNS VZV\ninfection was unexpected identified by metagenomic next-generation sequencing (mNGS).\nCase presentation: A 28-year-old HIV-infected patient presented with neurological symptoms for 3 days. The\npatient, who was not suspected of VZV infection at admission, quickly progressed to deep coma during the first 24\nh of hospitalization. An unbiased mNGS was performed on DNA extract from 300............
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