A 63-year-old man had left-sided chest pain and a skin rash.

VZV causes chickenpox (varicella) and shingles. Following initial infection, usually as varicella in childhood, VZV, one of the herpes family of viruses, remains dormant in the dorsal spinal root ganglion neurons and the fifth cranial nerve (CN V) ganglion neurons. Upon reactivation, a spectrum of clinical manifestations may occur including herpes zoster (shingles), postherpetic neuralgia, cranial neuropathies, Ramsay Hunt syndrome (geniculate neuralgia, nervus intermedius neuralgia, or herpes zoster oticus), cerebellar ataxia, myelitis, radiculitis, brachial plexus neuritis, motor neuropathies, encephalitis, thrombotic cerebral vasculopathy, keratitis, and so forth. Once herpes zoster rash resolves, many patients continue to suffer from pain persisting longer than 1 to 3 months (postherpetic neuralgia).