scholarly journals Caso clínico: Herpes Zoster diseminado en paciente adulta mayor inmunocompetente

2020 ◽  
Vol 12 (1) ◽  
pp. 58-62
Author(s):  
Johanna Cecilia Enríquez Cruz ◽  
Adriana Elizabeth Araujo Yánez ◽  
Sayonara del Rocío Zaputt Cabrera
Keyword(s):  
Herpes Zoster ◽  
Skin Diseases ◽  
Antiviral Treatment ◽  
Systemic Disease ◽  
Antiviral Agents ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Specific Therapy ◽  
Medical Background ◽  
Immunocompetent Patients

BACKGROUND: Disseminated cutaneous Herpes Zoster is defined as the presence of more than 20 vesicles outside the area and adjacencies of the primarily affected dermatome, the involvement of more than 2 contiguous dermatomes or the presence of systemic disease. Its prevalence among immunodepressed patients is 10- 40%, but between immunocompetent patients only isolated cases are reported. We present a case of an elderly immunocompetent patient, with no pathological history, that developed HZCD. CASE REPORT: An 89 year old woman, with no medical background, presented with 10 day evolution itchy, painful blistering lesions on the inner right thigh and the proximal third of the ipsilateral leg. Days after the lesions disseminated and the patient received topical treatment, she couldn’t specify the treatment; after 3 days her general condition worsened, and she was brought to the Emergency Room. EVOlUTION: Patient was diagnosed with Disseminated Herpes Zoster. She had a good outcome, after completing the intravenous antiviral treatment and she was discharged with no complications, after 10 days of being hospitalized. CONClUSION: Diagnosis of disseminated herpes zoster should be considered in both immunocompetent and immunocompromised patients. The outcome strongly depends on the promptness of the specific therapy instauration. KEYWORDS: HERPES ZOSTER, SKIN DISEASES, VESICULOBULLOUS, ANTIVIRAL AGENTS

scholarly journals Prostatic tuberculosis: case report

2008 ◽  
Vol 126 (4) ◽  
pp. 227-228 ◽  
Author(s):  
Daniel Sáenz-Abad ◽  
Santiago Letona-Carbajo ◽  
José Luis de Benito-Arévalo ◽  
Isabel Sanioaquín-Conde ◽  
Francisco José Ruiz-Ruiz
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Urine Culture ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Tuberculosis Case ◽  
Immunocompetent Patients

CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

scholarly journals Invasive aspergillosis in an immunocompetent patient with fever and a cardiac mass

2011 ◽  
Vol 3 (2) ◽  
pp. 12 ◽  
Author(s):  
Matthew LaBarbera ◽  
Lester B. Jacobson
Keyword(s):  
Differential Diagnosis ◽  
Invasive Aspergillosis ◽  
Respiratory Infection ◽  
Respiratory Illness ◽  
Immunocompetent Patient ◽  
Cardiac Mass ◽  
Immunocompromised Patients ◽  
Fatal Disease ◽  
Febrile Respiratory Illness ◽  
Immunocompetent Patients

Invasive aspergillosis is an often fatal disease that usually occurs in immunocompromised patients. We report a case of invasive aspergillosis presenting as a febrile respiratory infection with a cardiac mass in an immunocompetent patient. Invasive aspergillosis should be considered in the differential diagnosis of an otherwise undiagnosed febrile respiratory illness, even in immunocompetent patients. Echocardiography should be peformed to evaluate for endocarditis in such cases. Prompt initiation of appropriate antifungal therapy is warranted, even before the diagnosis of invasive aspergillosis is confirmed.

scholarly journals Disseminated cutaneous herpes zoster in an immunocompetent elderly patient

2014 ◽  
Vol 6 (3) ◽  
Author(s):  
Eric Gomez ◽  
Ivan Chernev
Keyword(s):  
Elderly Patient ◽  
Herpes Zoster ◽  
Clinical Characteristics ◽  
Immunocompetent Patient ◽  
Clinical Syndrome ◽  
Vesicular Rash ◽  
Immunocompetent Elderly Patient ◽  
Immunocompetent Patients ◽  
Baseline Demographic

Herpes zoster is a clinical syndrome which usually presents with a localized, vesicular rash in a dermatomal distribution. Cutaneous dissemination rarely occurs in immunocompetent patients, therefore little is known about the baseline demographic, clinical characteristics, management and outcome of these patients. Herein, we report a case of disseminated cutaneous herpes zoster in an immunocompetent patient along with a review and analysis of 28 cases previously reported in the literature.

Association between the risk for cardiovascular events and antiviral treatment for herpes zoster

2020 ◽  
Author(s):  
Jinkwon Kim ◽  
Jimin Jeon ◽  
Hye Sun Lee ◽  
Kyung-Yul Lee
Keyword(s):  
Herpes Zoster ◽  
Lower Risk ◽  
Cardiovascular Events ◽  
Primary Outcome ◽  
Cox Regression ◽  
Antiviral Treatment ◽  
Antiviral Agents ◽  
Cox Regression Analysis ◽  
Health Claims Data

Abstract Background Cardiovascular risk increases following herpes zoster. We investigated if the treatment with antiviral agents, steroids, and common cardiovascular medications was associated with the risk of postherpetic cardiovascular events. Methods This was a nationwide population-based, retrospective, cohort study using the National Health Insurance Service health claims data in Korea. We included patients with a first ever diagnosis of herpes zoster in 2003–2014 and no prior cardiovascular event. Primary outcome was the development of composites of myocardial infarction (ICD-10 code of “I21”) and stroke (“I60–63”) since the herpes zoster. We analyzed the exposure (intravenous or oral administration) to antiviral agents, steroids, antithrombotics, and statins within ± 7 days from the index date of herpes zoster diagnosis. Follow-up was performed until the development of primary outcome, death, or December 2015. Results Of 83,833 patients with herpes zoster, the proportion of patients who received the treatment with antiviral agents, steroids, antithrombotics, and statins were 90.5%, 48.0%, 9.0%, and 7.9%, respectively. During the 5.4 ± 3.1 years of mean follow-up period, 1,306 patients suffered the primary outcome. Multivariate Cox regression analysis demonstrated that treatment with antiviral agents (adjusted HR, 0.80; 95% CI, 0.69–0.93) and statins (adjusted HR, 0.67; 95% CI, 0.54–0.82) were significantly associated with the lower risk of primary outcome. Use of antithrombotics and steroids were not associated with the risk. Conclusions After herpes zoster, treatment with antiviral agents was significantly associated with lower risk of cardiovascular events. We need more information on the cardiovascular protective role of the herpes zoster treatments.

scholarly journals Pain and its Assessment in Herpes Zoster

1997 ◽  
Vol 8 (6_suppl) ◽  
pp. 31-36
Author(s):  
RH Dworkin
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Antiviral Treatment ◽  
Antiviral Agents ◽  
Future Research ◽  
Post Herpetic Neuralgia ◽  
Substantial Evidence ◽  
Acute Herpes Zoster ◽  
Prolonged Pain ◽  
Definition Of

Pain typically accompanies acute herpes zoster. In a proportion of patients, herpes zoster pain persists well beyond rash healing. This persisting pain is termed post-herpetic neuralgia (PHN). Because of the substantial personal and economic burdens caused by PHN, studies of the pathophysiology of herpes zoster pain and of the efficacy of antiviral treatment in reducing prolonged pain are of great importance. Different methods have been used to examine pain in research on herpes zoster and in clinical trials, making it difficult to compare across studies. There is substantial evidence, however, that demonstrates the importance of distinguishing acute pain from PHN. Several differences have been found between acute herpes zoster pain and PHN, including pathophysiological findings, risk factors and pain quality. Recommendations for the design and analysis of future trials of antiviral agents in herpes zoster have been recently proposed. These include a definition of PHN and recommended secondary end points for future trials. Adopting these recommendations in future research on herpes zoster pain, and in the design and analysis of future trials, will facilitate comparisons across studies of the pathophysiology and prevention of PHN.

scholarly journals Clinical Features, Endoscopic Findings, and Predictive Factors for Mortality in Tissue-Invasive Gastrointestinal Cytomegalovirus Disease between Immunocompetent and Immunocompromised Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Panu Wetwittayakhlang ◽  
Natthapat Rujeerapaiboon ◽  
Poowadon Wetwittayakhlung ◽  
Pimsiri Sripongpun ◽  
Nannapat Pruphetkaew ◽  
...  
Keyword(s):  
Survival Probability ◽  
Antiviral Treatment ◽  
Mortality Data ◽  
Inhospital Mortality ◽  
Immunocompromised Patients ◽  
Icu Admission ◽  
Significant Difference ◽  
Cmv Disease ◽  
Peto Test ◽  
Immunocompetent Patients

Background and Aims. Tissue-invasive gastrointestinal cytomegalovirus (TI-GI CMV) disease is common in immunocompromised patients, but the increasing prevalence in immunocompetent patients has been reported. This study compared the clinical manifestations, endoscopic features, treatment outcomes, and predictors for inhospital mortality of TI-GI CMV between immunocompromised and immunocompetent patients. Methods. Patients with HIV infection, malignancy, or receiving immunosuppressive agents (chemotherapy, high dose, or long-term corticosteroids) were defined as the immunocompromised group. Demographic and inhospital mortality data were obtained and retrospectively analyzed. Results. A total of 213 patients (89 immunocompetent) with histologically confirmed TI-GI CMV were enrolled. Immunocompetent patients were older (70 vs. 52 years; p < 0.001 ), had more GI bleeding as a presenting symptom (47.2% vs. 29.0%; p = 0.010 ), and shorter symptom onset (2 vs. 14 days, p = 0.018 ). Concomitant extra-GI involvement was only seen in the immunocompromised group (6.5% vs. 0%; p = 0.02 ). Diffuse GI tract (14.5% vs. 4.5%; p = 0.032 ) and esophageal involvement (14.5% vs. 5.6%; p = 0.046 ) were more frequent in the immunocompromised, while small bowel involvement was more frequent in the immunocompetent group (19.1% vs. 8.1%; p = 0.029 ). An overall inhospital mortality was 27.7%. There was no significant difference in inhospital survival probability between the two groups (Peto-Peto test, p = 0.65 ). ICU admission (hazard ratio [HR] 7.21; 95% CI 2.55-20.36), sepsis or shock (HR 1.98; 95% CI 1.08-3.66), malnutrition (HR 2.62; 95% CI 1.05-7.01), and receiving chemotherapy (HR 5.2; 95% CI 1.89-14.29) were independent factors for inhospital mortality. Antiviral treatment for more than 14 days was the only protective factor to improve survival (Peto-Peto test, p < 0.001 ). Conclusions. Immunocompetent and immunocompromised patients with TI-GI CMV disease had distinct clinical and endoscopic characteristics. There was no significant difference in the inhospital mortality between the two groups. The factors for mortality were ICU admission, sepsis/shock, malnutrition, and receiving chemotherapy. Early diagnosis and initiation of antiviral treatment might improve the survival probability.

scholarly journals A Rare Case of an Immunocompetent Male With Zoster Meningitis

2020 ◽  
Vol 8 ◽  
pp. 232470962095221
Author(s):  
Mohammed Ali Faluk ◽  
Shraddhadevi Makadia ◽  
Ramy Abdelmaseih ◽  
S. Mustajab Hasan ◽  
Khalid Abusaada
Keyword(s):  
Herpes Zoster ◽  
Virus Infection ◽  
Varicella Zoster Virus ◽  
Rare Case ◽  
The Elderly ◽  
Varicella Zoster Virus Infection ◽  
Immunocompromised Patients ◽  
Varicella Zoster ◽  
Immunocompetent Patients ◽  
Uncommon Complication

Varicella zoster meningitis is an uncommon complication of herpes zoster, especially in immunocompetent patients. We report a case of a healthy 45-year-old male who developed aseptic meningitis as a result of reactivated varicella zoster virus infection. This case highlights the importance of remaining cognizant of varicella zoster virus as a cause of meningitis in not only the elderly or immunocompromised patients but also in patients who are healthy.

scholarly journals Disseminated Cutaneous Mycobacterium Fortuitum-Chelonae Complex Infection in a Young, Immunocompetent Patient: A Case Report

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Atikah Rozhan ◽  
Kahairi Abdullah ◽  
Zamzil Amin Asha'ari
Keyword(s):  
Case Report ◽  
Drug Therapy ◽  
Skin Infection ◽  
Immunocompetent Patient ◽  
Mycobacterium Fortuitum ◽  
Immunocompromised Patients ◽  
Skin Infections ◽  
Diagnostic Dilemma ◽  
Rapidly Growing Mycobacteria ◽  
Immunocompetent Patients

Mycobacteria fortuitum and chelonae are a group of Rapidly Growing Mycobacteria (RGM) that can cause skin infections, most commonly in immunocompromised patients. RGM can also infect immunocompetent patients, but the disease is usually localized. Immunocompetent patients infected by RGM usually had a predisposing condition leading to the skin infection. We present a case of an immunocompetent patient with no predisposing factors, who presented with a chronic lesion on his neck that disseminated to his axilla. Culture and species identification from the skin biopsy revealed Mycobacterium fortuitum-chelonae complex. The patient was treated with a combination of surgery and multi-drug therapy. This case report highlights the rarity of cutaneous RGM infections encountered in ENT setting and the diagnostic dilemma due to the non-typical characteristics of skin lesion in RGM infections.

A Rare Case of Tuberculous Prostatitis

2016 ◽  
Vol 1 (2) ◽  
pp. 33
Author(s):  
Nurul Yaqeen Mohd Esa ◽  
Mohammad Hanafiah ◽  
Marymol Koshy ◽  
Hilmi Abdullah ◽  
Ahmad Izuanuddin Ismail ◽  
...  
Keyword(s):  
Rare Case ◽  
Correct Diagnosis ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Tuberculosis Infection ◽  
Advanced Age ◽  
Immunocompromised Patients ◽  
Prostatic Biopsy ◽  
High Clinical Suspicion

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

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