Varicella zoster virus infection presenting as isolated diplopia: a case report.

BACKGROUND: Involvement of trochlear nerve during Varicella Zoster Virus (VZV) Infection has been rarely described, and always in association with skin rash. CASE PRESENTATION: We describe the case of a patient with VZV infection presenting as isolated diplopia due to fourth cranial nerve palsy. The diagnosis has been obtained through the application of a standardized molecular diagnostic panel, and diplopia resolved after specific antiviral and corticosteroid therapy. CONCLUSION: This case evidences that clinicians should be aware of atypical VZV infection, even in the absence of the typical skin rash.