Varicella-zoster virus infection in pregnancy: a case of aseptic meningitis before 20 weeks gestation and review of the literature

This represents the fourth reported case of VZV meningitis during pregnancy globally and the first occurring before 20 weeks of gestation with preterm delivery as a unique outcome. Key implications: (1) Early-to-mid gestation VZV infection may affect pregnancy outcomes through distinct mechanisms; (2) multidisciplinary management is critical for optimizing maternal-fetal prognosis; and (3) further investigation is needed to elucidate the relationship between infection timing and preterm birth.