AIDS-related varicella zoster meningoencephalitis and radicular pain without cutaneous eruption

Herpes zoster (shingles) is an acute, painful, vesicular, and cutaneous eruption caused by varicella zoster virus, the same virus which causes chicken pox. It is due to the reactivation of the virus which remains dormant in sensory ganglions following chicken pox. It is usually confined to a single dermatome but may involve 2-3 dermatomes. Typically, it is a unilateral lesion which can affect both cranial and peripheral nerves. It is usually a self-limiting disease; however, it may cause significant morbidity especially in the elderly. It is more common in older people and individuals with immunocompromised conditions. Antiviral drugs can shorten the duration and the severity of the illness and need to be started as soon as possible after the appearance of the rash. Gabapentin and tricyclic antidepressant are effective in postherpetic neuralgia. Vaccine can reduce the risk of infection and its associated pain. Typically, it occurs once in a lifetime, but some individuals may have more than one episode.

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Detection of varicella-zoster virus DNA in ocular samples from patients with uveitis but no cutaneous eruption

Eye ◽

10.1038/eye.1994.169 ◽

1994 ◽

Vol 8 (6) ◽

pp. 684-687 ◽

Cited By ~ 21

Author(s):

P Stavrou ◽

S M Mitchell ◽

J D Fox ◽

M W Hope-Ross ◽

P I Murray

Keyword(s):

Varicella Zoster Virus ◽

Cutaneous Eruption ◽

Varicella Zoster

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Chronic Varicella-Zoster Virus Myelitis Without Cutaneous Eruption in a Patient with AIDS: Report of a Fatal Case

Clinical Infectious Diseases ◽

10.1093/clinids/21.4.986 ◽

1995 ◽

Vol 21 (4) ◽

pp. 986-988 ◽

Cited By ~ 17

Author(s):

F. A. Manian ◽

M. Kindred ◽

K. H. Fulling

Keyword(s):

Varicella Zoster Virus ◽

Fatal Case ◽

Cutaneous Eruption ◽

Varicella Zoster

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PROFIL HERPES ZOSTER DI POLIKLINIK KULIT DAN KELAMIN RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JANUARI – DESEMBER 2012

e-CliniC ◽

10.35790/ecl.2.1.2014.3671 ◽

2014 ◽

Vol 2 (1) ◽

Author(s):

Sahriani HR

Keyword(s):

Herpes Zoster ◽

Retrospective Study ◽

Viral Infection ◽

Varicella Zoster Virus ◽

Medical Records ◽

Radicular Pain ◽

Virus Reactivation ◽

Varicella Zoster ◽

Drug Of Choice ◽

Vesicular Lesion

Abstract: Background – Herpes zoster that is also called with shingles, dampa, or cacar ular is a disease caused by the infection of varicella zoster virus (VZV) and affects the skin and mucosa. This infection is a virus reactivation after primer infection characterized with unilateral radicular pain and vesicular lesion that manifests on the skin and its innervation. Objctive – The aim of this research is to find out the profile of outpatient diagnosed with herpes zoster in Dermatovenereology Department RSUP Prof. DR. R. D. Kandou Manado from January to December 2012. Methods – It is a retrospective study that describe several factors related to the subjects, using medical records data from January to December 2012. There were 22 patients evaluated. Result – 2% of 1096 new patients in the period of January to December 2012 were diagnosed as herpes zoster. 73% were 45 – 64 years old, with 54,5% men and 45,4% women, oftalmicus nerve involved counted to 32%, the most common therapy were the combination of Antivirus + Analgesic + Neurovitamin (36,3%). Conclusion – Increasing of the age could be the factor to reactivate the viral infection. The incidence were not affected by sex. Antivirus remain the drug of choice to treat herpes zoster.Key words : herpes zoster – reactivation – virus Abstrak: Latar Belakang – Herpes zoster atau disebut juga dengan shingles, dampa, cacar ular adalah penyakit yang disebabkan oleh infeksi virus varisela – zoster (VVZ) yang menyerang kulit dan mukosa. Infeksi ini merupakan reaktivasi virus yang terjadi setelah infeksi primer yang ditandai dengan adanya nyeri radikuler unilateral serta timbulnya lesi vesikuler yang terbatas pada dermatom yang dipersarafi. Tujuan Penelitian – Mengetahui profil herpes zoster di poliklinik Kulit dan Kelamin RSUP Prof. Dr. R. D. Kandou Manado periode Januari – Desember 2012. Metode – Penelitian ini bersifat deskriptif retrospektif, yaitu mendeskripsikan beberapa faktor yang berhubungan dengan subjek penelitian yang ada. Data penelitian diambil dari rekam medik periode Januari – Desember 2012. Jumlah sampel penelitian sebanyak 22 orang. Hasil Penelitian – Terdapat 2% penderita herpes zoter dari 1096 pasien periode Januari – Desember 2012. Pada umur 45 – 64 tahun terdapat 73% penderita, laki – laki 54,5% dan perempuan 45,5%, lokasi yang sering terkena adalah oftalmikus 32%, serta kombinasi terapi yang sering digunakan adalah Antivirus + Analgesik + Neuronvitamin 36,3%. Kesimpulan – Peningkatan usia dapat memicu reaktivasi virus. Kejadian herpes zoster tidak dipengaruhi oleh jenis kelamin. Obat yang sering digunakan adalah antivirus.Kata kunci : herpes zoster – reaktivasi – virus

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Poster 149 Varicella-Zoster Infection Presenting with an Acute Disk Herniation with Radicular Pain: A Case Report

PM&R ◽

10.1016/j.pmrj.2012.09.773 ◽

2012 ◽

Vol 4 ◽

pp. S241-S241

Author(s):

Ajay Patel ◽

Eugene Y. Roh

Keyword(s):

Case Report ◽

Radicular Pain ◽

Disk Herniation ◽

Varicella Zoster ◽

Varicella Zoster Infection

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Acute meningoencephalomyelitis due to varicella-zoster virus in an AIDS patient: report of a case and review of the literature

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822011000600026 ◽

2011 ◽

Vol 44 (6) ◽

pp. 784-786 ◽

Cited By ~ 5

Author(s):

Marcelo Corti ◽

Norberto Trione ◽

María Florencia Villafañe ◽

Daniel Risso ◽

Claudio Yampolsky ◽

...

Keyword(s):

Varicella Zoster Virus ◽

Infected Individual ◽

Neurological Complication ◽

Chain Reaction ◽

Specific Therapy ◽

Cutaneous Eruption ◽

Varicella Zoster ◽

Intravenous Acyclovir ◽

Polymerase Chain ◽

Acyclovir Therapy

Varicella-zoster virus (VZV) meningoencephalomyelitis is a rare but severe neurological complication of VZV reactivation in immunocompromised patients. We report the case of an HIV-infected individual who developed an acute and severe meningoencephalomyelitis accompanied by a disseminated cutaneous eruption due to VZV. The presence of VZV DNA in cerebrospinal fluid was confirmed by polymerase chain reaction (PCR) technique. The patient started undergoing an intravenous acyclovir therapy with a mild recovery of neurological manifestations. Varicella-zoster virus should be included as a cause of acute meningoencephalomyelitis in patients with AIDS. Early diagnosis followed by specific therapy should modify the rapid and fulminant course for this kind of patients.

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VARICELLA-ZOSTER VIRUS CNS DISEASE CLINICAL FEATURES IN UKRAINIAN PATIENTS. PROSPECTIVE STUDY

Wiadomości Lekarskie ◽

10.36740/wlek201909211 ◽

2019 ◽

Vol 72 (9) ◽

pp. 1765-1768

Author(s):

Pavel A. Dyachenko

Keyword(s):

Herpes Zoster ◽

Varicella Zoster Virus ◽

Clinical Features ◽

Brain Lesion ◽

Clinical Manifestations ◽

Radicular Pain ◽

Cns Injury ◽

Varicella Zoster ◽

Vesicular Rash ◽

Mri Scans

Introduction: Herpes zoster (HZ), or shingles, is localized disease characterized by unilateral radicular pain and a vesicular rash limited to the area of skin innervated by a single dorsal root or cranial sensory ganglion. Whereas varicella, or chickenpox, results from primary exogenous varicella-zoster virus (VZV) infection, HZ is caused by reactivation of endogenous VZV that has persisted in latent form within sensory ganglia following an earlier episode of chickenpox. The aim: To explore the clinical features, diagnosis, and treatment of CNS injury caused by VZV infection in a prospective single center study from January 2014 to January 2018. Materials and methods: 117 adult patients, among which young women predominated with confirmed VZV infection were analyzed in the study. CSF and blood contents, antibody for herpes zoster M and G classes, and MRI scans have been studied, but the crucial diagnostic sign was the presence of specific viral DNA in the CSF or blood. The main clinical manifestations of the disease were ganglionitis and ganglioradiculoneuritis. Another brain lesion like uveitis, encephalitis and vasculitis were observed also. A clinical case of an unusual course of VZV-infection is given. Results and conclusions: The most common clinical variants of HZ were ganglionitis (69.7%). Cranial localization was observed in 31% of patients, spinal one – in 38.7%, injury to the meninges was found in 16.3% of patients.

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Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2003.sepoct02 ◽

2003 ◽

Vol 8 (5) ◽

pp. 4-12

Author(s):

Lorne Direnfeld ◽

James Talmage ◽

Christopher Brigham

Keyword(s):

Upper Extremity ◽

Radicular Pain ◽

Illness Behavior ◽

Orthopedic Surgeon ◽

First Case ◽

Clinical Presentations ◽

Whole Person ◽

Physical Examinations ◽

Upper Extremity Impairment ◽

The Individual

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).

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