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

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.

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Thigita A. Pandaleke ◽  
Herry E. J. Pandaleke ◽  
Ratna I. Susanti ◽  
Julieta D. P. Dotulong

Abstract: Herpes zoster (HZ) is an acute vesicular eruption caused by latent varicella zoster virus (VVZ) reactivation in sensory ganglia after primary infection. Its incidence increases with age and it is rarely found in children. We reported a case of 10-year-old male with blisters on the right side of his stomach and back 3 days ago. The patient was suffered from fever, common cold, and cough a week before, and had a history of varicella at 5 years old. Dermatologic status showed multiple vesicles on erythematous base at the anterior dan posterior sides of his right lumbar region. The Tzank test showed multinucletaed giant cells. Acyclovir resulted in significant improvement after 7- day therapy. Conclusion: Diagnosis of herpes zoster was based on anamnesis, physical examination, and laboratory findings. Antiviral drugs was aimed to reduce complications and viral shedding.Keywords: Herpes zoster, childAbstrak: Herpes zoster (HZ) merupakan erupsi vesikuler akut yang disebabkan oleh reaktivasi dari virus varisela zoster (VVZ) laten pada ganglia sensoris yang sebelumnya terpajan dengan infeksi primer varisela. Insiden HZ meningkat seiring pertambahan usia dan jarang ditemukan pada anak-anak. Kami melaporkan kasus seorang anak laki-laki, 10 tahun, dengan bintil-bintil berair di perut dan punggung sebelah kanan sejak 3 hari lalu. Riwayat demam, batuk dan pilek 1 minggu sebelum timbul lesi. Riwayat varisela pada usia 5 tahun. Status dermatologis ditemukan vesikel multipel berisi cairan jernih yang tersusun bergerombol di atas kulit yang eritema di regio lumbar dekstra anterior dan posterior. Tes Tzank memperlihatkan sel raksasa berinti banyak. Pasien diterapi dengan asiklovir oral selama 7 hari dan menunjukkan perbaikan yang bermakna. Simpulan: Anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang kasus ini khas untuk herpes zoster. Pemberian obat antiviral bertujuan untuk mengurangi komplikasi dan menurunkan viral shedding.Kata kunci: herpes zoster, anak


Author(s):  
Samit Jain ◽  
Sarika Jain ◽  
Sewta Jain

Varicella zoster virus (VZV) is the causative agent for Herpes Zoster. Varicella-zoster virus reactivates from its latent state in posterior dorsal ganglion results in its spread from the ganglion to the corresponding dermatomes producing neurocutaneous signs and symptoms and can only occur in someone who has history of chickenpox (varicella). When it reactivates, it travels from the nerve body to the endings in the skin, producing blisters. Symptoms such as odontalgia, could be present during the prodromal stage. With an increase in the number of herpes zoster patients, the dentist must be familiar to the signs and symptoms of the prodromal manifestations of herpes zoster of the trigeminal nerve. This article focuses on the difficulties in management of such cases and one such case is reported here. Key Words: Varicella-zoster virus; herpes zoster; reactivate; dermatomes; prodormal stage


PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0176845 ◽  
Author(s):  
Luigi Marangi ◽  
Grazina Mirinaviciute ◽  
Elmira Flem ◽  
Gianpaolo Scalia Tomba ◽  
Giorgio Guzzetta ◽  
...  

2021 ◽  
Vol 13 (2) ◽  
pp. 162-167
Author(s):  
Bing-Shiau Shang ◽  
Cheng-Jui Jamie Hung ◽  
Ko-Huang Lue

Herpes zoster is a relatively rare infectious disease in the pediatric population, as compared with adults, which is due to the reactivation of latent Varicella−Zoster virus. We report a 7-year-old child without any history of varicella, who first experienced skin pain and later presented skin lesions in dermatomal distribution. Finally, the patient was diagnosed with herpes zoster. We aim to emphasize that herpes zoster could occur in immunocompetent children and may be due to the reactivation of the vaccine strain or previous subclinical infection.


2021 ◽  
Vol 19 ◽  
pp. 205873922110212
Author(s):  
Nan Zhao ◽  
Yulan Geng ◽  
Yexian Li ◽  
Lijuan Liu ◽  
Yanjia Li ◽  
...  

Herpes zoster (HZ), caused by the varicella-zoster virus, is an infectious skin disease that rarely recurs after initial presentation. The mechanism underlying HZ recurrence is currently under investigation. In this article, we report a case of HZ relapse within 1 month. Analysis of patient’s clinical manifestations, histopathological features, and flow cytometry results indicated that the absolute and percentage values of B cells were below the lower limit. We hypothesized that the patient had abnormal humoral immune function, which may be one reason leading to the HZ relapse within 1 month. The findings of this case will serve as useful reference for HZ recurrence for clinicians. This case was impactful and added to the literature on HZ recurrence.


2008 ◽  
Vol 12 (3) ◽  
pp. 245-247 ◽  
Author(s):  
Cheol-In Kang ◽  
Chang-Min Choi ◽  
Tae-Sung Park ◽  
Dong-Jun Lee ◽  
Myoung-don Oh ◽  
...  

2021 ◽  
pp. 148-153
Author(s):  
Tetsuko Sato ◽  
Takenobu Yamamoto ◽  
Yumi Aoyama

Varicella zoster virus (VZV)-associated meningitis is usually progressive and can be fatal, and early diagnosis and aggressive treatment with intravenous antivirals such as acyclovir (ACV) are required in immunocompromised patients. Patients receiving corticosteroids and immunosuppressive therapy have a significantly higher risk of VZV-associated meningitis. In this report, we describe an unusual case of herpes zoster (HZ) in a young woman who was first diagnosed during tapering of prednisone for dermatomyositis. The skin lesions affected the left L2 and L3 dermatomes, which is unusual in VZV-associated meningitis. Despite showing a good rapid response to antivirals, she developed VZV-associated meningitis immediately after discontinuation of ACV. This phenomenon is often called rebound VZV reactivation disease and occurs after discontinuation of antivirals. This case was notable in that the affected dermatomes were distant from the cranial nerves. Thus, progression of HZ to VZV reactivation-associated meningitis can occur even in appropriately treated HZ patients. Continuation of antivirals beyond 1 week in patients on immunosuppressive therapy may be associated with a decreased risk of severe rebound VZV disease, such as VZV-associated meningitis.


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