UMass Chan Medical School Faculty Publications

UMMS Affiliation

Department of Emergency Medicine

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Emergency Medicine | Infectious Disease | Virus Diseases


INTRODUCTION: As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads across the globe, physicians face the challenges of a contagious pandemic including which patients to isolate, how to conserve personal protective equipment, and who to test. The current protocol at our hospital is to place anyone with new cough, dyspnea, or fever into airborne and contact precautions and consider them for testing. Unfortunately, the symptomatic presentations of coronavirus disease 2019 (COVID-19) are proving more variable than previously thought.

CASE REPORT: Our case of COVID-19 presented with headache and then progressed to a meningitis-like illness with co-existing shingles rash.

CONCLUSION: COVID-19 can have a variety of initial presentations that are not the classic respiratory symptoms and fever. These presenting symptoms of COVID-19 can include a meningitis-like illness, as our case report indicates. The wide variety of presentations of COVID-19 may warrant widespread testing to identify cases, protect healthcare workers, and prevent the spread of this pandemic.


COVID-19, novel coronavirus, meningitis, shingles, presenting symptoms

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Copyright: © 2020 Packwood et al. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: licenses/by/4.0/

DOI of Published Version



Packwood R, Galletta G, Tennyson J. An Unusual Case Report of COVID-19 Presenting with Meningitis Symptoms and Shingles. Clin Pract Cases Emerg Med. 2020 Aug;4(3):316-320. doi: 10.5811/cpcem.2020.4.47557. PMID: 32926675; PMCID: PMC7434230. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Clinical practice and cases in emergency medicine

PubMed ID


Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.