Aims To highlight possible and may be fatal complications of Varicella Zoster virus (VZV) infection.

Method We report a case of an infant with VZV infection who developed meningeococcal sepsi, meningeococcal meningitis, VZV encephalitis and subdural empyema.

Results A 3 month, previously well and developmentally normal male child was admitted with skin rash. He had contact with varicella zoster infection. His initial inflammatory markers were high. He was treated as Chicken pox. His blood culture grew Nisseria Meningitidis, treated with intravenous antibiotics. He remained unwell with poor response to antibiotics. A lumbar puncture was then performed. This revealed a picture consistent with bacterial meningitis. CSF PCR was positive for N. Meningitidis as well as for VZV.A week after admission he started to have seizures. This required intubation and PICU admission. A brain CT showed to bilateral subdural collection. He was assessed at 10 month of age and found to have no residual disabilities.

Conclusion VZV infection complicated by meningococcal sepsis and meningitis is well reported in the literature; subdural empyema is reported on few occasions; however we found no report with all these complications in a single patient nor in an infant.