scholarly journals Zoster-associated limb paralysis mimicking acute stroke: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Chamara Dalugama ◽  
Ruwanthi Jayasinghe ◽  
Nimanthi Rathnayaka ◽  
Arjuna Medagama
Keyword(s):  
Varicella Zoster Virus ◽  
Rare Complication ◽  
Febrile Illness ◽  
Acute Onset ◽  
Brachial Plexopathy ◽  
Motor Neuropathy ◽  
Varicella Zoster ◽  
History Of ◽  
Brachial Plexus Neuritis ◽  
Peripheral Motor

Abstract Background Varicella zoster virus is a Deoxyribonucleic acid (DNA) virus exclusively affecting humans. Reactivation of varicella zoster virus causes herpes zoster with vesicular eruptions in a restricted dermatomal distribution. Peripheral motor neuropathy is a very rare complication of varicella zoster virus. Case presentation A 57-year-old previously well Sri Lankan female presented with acute onset painful weakness of the left upper limb with a preceding history of a febrile illness. Subsequently she developed vesicular eruptions in the dermatomal distribution of cervical 5, 6, and 7. Electromyography was suggestive of acute denervation of cervical 5, 6, and 7 myotomes. Diagnosis of zoster-associated brachial plexopathy was made, and the patient was treated with acyclovir, steroids, and analgesics. She made a good recovery. Conclusion Brachial plexus neuritis due to varicella zoster infection should be considered in an acute monoparesis of a limb as it is a treatable and reversible condition

Hospital Experience with Varicella-Zoster Virus

1986 ◽  
Vol 7 (6) ◽  
pp. 312-316 ◽  
Author(s):  
Keith Krasinski ◽  
Robert S. Holzman ◽  
Rita LaCouture ◽  
Alfred Florman
Keyword(s):  
Infection Control ◽  
Varicella Zoster Virus ◽  
Hospital Staff ◽  
Control Measures ◽  
Varicella Zoster ◽  
Staff Members ◽  
Infection Control Measures ◽  
Serologic Testing ◽  
Care Workers ◽  
History Of

AbstractVaricella-zoster virus (VZV), one of the most common highly communicable agents of disease, stimulates aggressive infection control measures. In a 1-year period, at one hospital, at least 93 inpatients (82 adult patients, 11 pediatric patients) and 2 hospital staff with active varicella-zoster infections served as potential sources of nosocomial infection. Six incidents of exposure to the virus that occurred without the protection of standard infection control precautions were investigated by the infection control surveillance team. One hundred fifty-six patients and 353 hospital staff were exposed. Fifty-one patients had no history of varicella-zoster infection, but only five were susceptible by serologic testing. One hundred one staff members had no history of varicella-zoster, but only 11 were susceptible by serologic testing. These exposures resulted in three secondary varicella-zoster infections, six courses of varicella-zoster immune globulin prophylaxis and furlough of 13 staff members. Epidemiologic investigation consumed approximately 356 hours of staff time, and management of exposed persons cost approximately $41,500. Prospective knowledge of the immune status of health care workers would vastly decrease the time and effort required to control hospital VZV exposures.

Avoiding a lumbar puncture may be a rash decision: a case report of varicella-zoster virus-associated radiculopathy in advanced HIV infection

2019 ◽  
Vol 30 (10) ◽  
pp. 1031-1033
Author(s):  
Emma Wallis ◽  
Bahij Al-Hakim ◽  
Paul Holmes ◽  
Sam Douthwaite ◽  
Ranjababu Kulasegaram
Keyword(s):  
Varicella Zoster Virus ◽  
Lumbar Puncture ◽  
Case Reports ◽  
Response To Treatment ◽  
High Dose ◽  
Serum Samples ◽  
Cd4 Cell Count ◽  
Varicella Zoster ◽  
Intravenous Acyclovir ◽  
History Of

A 34-year-old man recently diagnosed with advanced human immunodeficiency virus infection (CD4 cell count of 139 cells/mm3), not yet started on antiretroviral medications, presented to hospital with a ten-day history of left leg weakness and difficulty walking. He described a childhood history of chickenpox with previous shingles over his buttock over three years ago. Examination revealed reduced power in the left hip and knee flexors and absent knee and adductor reflexes. Lumbar punctures were performed and polymerase chain reaction (PCR) detected varicella-zoster virus (VZV) DNA. Concurrent serum samples for VZV PCR were negative. The patient was diagnosed with VZV radiculopathy and treated with high-dose intravenous acyclovir. Within two days, neurological signs improved. Previous case reports define VZV radiculopathy by a temporal and geographical relationship with a zoster rash. Our diagnosis was based on a clinical picture of radiculopathy with virological evidence in CSF and confirmed by a dramatic clinical response to treatment. We propose that lumbar puncture and detection of VZV DNA by PCR in the cerebrospinal fluid (CSF) is an invaluable investigation that should be considered in the workup of immunosuppressed patients presenting with a radiculopathy.

scholarly journals Painless Multidermatomal Herpes Zoster in an Immunocompetent Elderly Male: a Case Report

2015 ◽  
Vol 7 (4) ◽  
pp. 172-180 ◽  
Author(s):  
Shikhar Ganjoo ◽  
Mohinder Pal Singh Sawhney ◽  
Dikshak Chawla
Keyword(s):  
Herpes Zoster ◽  
Varicella Zoster Virus ◽  
Ganglion Cells ◽  
Giant Cells ◽  
Elderly Male ◽  
Left Groin ◽  
Varicella Zoster ◽  
Patient Reported ◽  
History Of ◽  
Serology Test

Abstract The varicella-zoster virus is the cause of both varicella and herpes zoster. The primary infection of varicella includes viremia and a widespread eruption, after which the virus persists in nerve ganglion cells, usually sensory. Herpes zoster is the result of reactivation of this residual latent virus. The first manifestation of zoster is usually pain, which may be severe and accompanied by fever, headache, malaise and tenderness localized to one or more nerve roots. The lymph nodes draining the affected area are enlarged and tender. Occasionally, the pain is not followed by eruption (zoster sine herpete). We hereby report an 85-year-old otherwise healthy male patient with a 3-day history of a non-painful rash on the left side of abdomen, pubic and penile regions, left groin and the left leg. He denied any pain and/or abnormal sensations before the rash onset. On examination, there were closely grouped multiple vesicles over the anterior left abdominal wall, left groin, thigh, knee and left upper quarter of penis, involving the left T12, L1-L4 and S2 dermatomes. The patient reported no pain, fever, rigor or any other symptoms; he had no associated cervical, axillary or inguinal lymphadenopathy. He denied any abdominal pain, nausea, vomiting, any weakness or sensory changes in the limbs. There was no history of penile numbness, urinary retention, and increased frequency of micturition or constipation. The varicella-zoster virus serology test performed by Calbiotech VZV IgG ELISA Kit (Calbiotech, Spring Valley, Canada) was strongly positive. The human immunodeficiency virus serology test, as well as herpes simplex virus type 1 and type 2 serology tests performed by ELISA were all negative. The Tzanck smear, stained with Giemsa, demonstrated multinucleated giant cells. The patient responded well to valacyclovir with complete clearance of lesions within one week. An extensive PubMed search revealed only few reports of painless herpes zoster. We present a rather peculiar case of painless herpes zoster in an elderly patient with no apparent systemic immunosuppression, with severe involvement affecting multiple adjacent and one remote dermatome. We hereby propose the term ”herpes zoster sine algesia” in cases where eruption is not followed by pain.

Screening Healthcare Workers for Varicella-Zoster Virus: Can We Trust the History?

2004 ◽  
Vol 25 (7) ◽  
pp. 595-598 ◽  
Author(s):  
Maha Almuneef ◽  
Ziad A. Memish ◽  
Mostafa F. Abbas ◽  
Hanan H. Balkhy
Keyword(s):  
Varicella Zoster Virus ◽  
Predictive Value ◽  
Healthcare Workers ◽  
Middle Eastern ◽  
Enzyme Linked Immunosorbent Assay ◽  
New Employees ◽  
Varicella Zoster ◽  
History Of ◽  
Serologic Screening ◽  
New Recruits

AbstractObjective:To determine the relationship between immunity and a history of chickenpox based on a self-administered questionnaire.Methods:We investigated immunity to varicella-zoster virus in a cohort of newly recruited employees with different job categories and different nationalities using enzyme-linked immunosorbent assay IgG.Results:There were 1,058 new recruits. Of these, 890 (84%) were immune and 168 (16%) were susceptible. The susceptibility rate was 23% (n = 77) for Asian, 15% (n = 14) for South African, 13% (n = 66) for Middle Eastern, and 9% (n = 11) for Western employees. Physicians were more likely to be immune (93%) than were nurses (85%), medical technicians (75%), or administrative clerks (84%). Seropositivity was not affected by age or gender. The positive predictive value of a history of chickenpox for the seropositivity was 89% (511 of 574); the negative predictive value was 22% (105 of 484). History of chickenpox had a sensitivity of 57% (511 of 890) and a specificity of 63% (105 of 168).Conclusions:The varicella-zoster virus seroprevalence among new employees was low, posing an important risk to existing employees and patients. Positive or negative history of chickenpox was an unreliable indicator of susceptibility among healthcare workers of different nationalities. Serologic screening of all employees and vaccination of those susceptible was recommended.

scholarly journals Varicella zoster virus in American Samoa: seroprevalence and predictive value of varicella disease history in elementary and college students

2013 ◽  
Vol 142 (5) ◽  
pp. 1002-1007 ◽  
Author(s):  
A. MAHAMUD ◽  
J. LEUNG ◽  
Y. MASUNU-FALEAFAGA ◽  
E. TESHALE ◽  
R. WILLIAMS ◽  
...  
Keyword(s):  
College Students ◽  
Elementary Students ◽  
Varicella Zoster Virus ◽  
American Samoa ◽  
Varicella Vaccination ◽  
Igg Antibodies ◽  
Predictive Values ◽  
Varicella Zoster ◽  
The Us ◽  
History Of

SUMMARYThe epidemiology of varicella is believed to differ between temperate and tropical countries. We conducted a varicella seroprevalence study in elementary and college students in the US territory of American Samoa before introduction of a routine varicella vaccination programme. Sera from 515 elementary and 208 college students were tested for the presence of varicella-zoster virus (VZV) IgG antibodies. VZV seroprevalence increased with age from 76·0% in the 4–6 years group to 97·7% in those aged ⩾23 years. Reported history of varicella disease for elementary students was significantly associated with VZV seropositivity. The positive and negative predictive values of varicella disease history were 93·4% and 36·4%, respectively, in elementary students and 97·6% and 3·0%, respectively, in college students. VZV seroprevalence in this Pacific island appears to be similar to that in temperate countries and suggests endemic VZV circulation.

scholarly journals Prevalence of Anti-Varicella-Zoster Virus Antibodies in French Infants under 15 Months of Age

2009 ◽  
Vol 16 (4) ◽  
pp. 484-487 ◽  
Author(s):  
Didier Pinquier ◽  
Arnaud Gagneur ◽  
Laurent Balu ◽  
Olivier Brissaud ◽  
Christèle Gras Le Guen ◽  
...  
Keyword(s):  
Varicella Zoster Virus ◽  
Pediatric Emergency ◽  
Rapid Decline ◽  
Time Resolved ◽  
Varicella Zoster ◽  
Emergency Units ◽  
History Of ◽  
Low Levels ◽  
First Time ◽  
Kinetics Of

ABSTRACT Varicella is a widespread disease of childhood resulting from primary infection with varicella-zoster virus (VZV). The objective of this study was to determine the kinetics of the decline of maternal anti-VZV antibodies in French infants between birth and the age of 15 months in order to estimate the duration of passively acquired maternal anti-VZV immunoglobulin G (IgG). This prospective multicenter study was conducted between October 2005 and January 2007 in the pediatric wards and/or pediatric emergency units of seven French hospitals scattered throughout the country. The level of anti-VZV IgG antibodies in serum was measured by a time-resolved fluorescence immunoassay (TRFIA) (the threshold considered positive is 150 mIU/ml). A total of 345 infants were included. Seventy-seven percent of mothers reported a history of varicella. A rapid decline in the prevalence of anti-VZV antibodies was observed during the first few months of life, with the mean antibody titer decreasing from 536 mIU/ml at birth and through 1 month to below the 150-mIU/ml threshold at 3 to 4 months. The half-life of passively acquired maternal immunoglobulins was around 6 weeks. Based on a large number of subjects, this study clearly demonstrated, for the first time in France, high levels of passively acquired maternal antibodies during the neonatal period, and it allowed us to estimate the duration of passively acquired maternal anti-VZV IgG in French infants. After 4 to 5 months, infants had very low levels of maternal anti-VZV IgG, below the 150-mIU/ml cutoff of the VZV IgG TRFIA.

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