scholarly journals Herpes zoster in an immunocompetent infant with a history of varicella in early infancy and after a minor injury - case report and literature review

2021 ◽  
pp. 74-74
Author(s):  
Jovana Dimic ◽  
Boris Jegorovic

Introduction. Chickenpox is a common pediatric disease, while herpes zoster (HZ) is rare among children, especially among infants. HZ in infancy may appear after intrauterine or postnatal infection with varicella-zoster virus (VZV). We report on a case of HZ in an immunocompetent infant who had a history of chickenpox in early infancy. Case outline. A seven-month-old male infant was presented with skin changes in the left T1 and T2 dermatomes. Skin changes appeared eight days after the infant had a mild left-arm traction injury. The patient?s medical history revealed that he had a mild form of chickenpox at the age of three and a half months. After the clinical diagnosis of HZ was made, he was treated with oral acyclovir 20 mg/kg every six hours for five days and had complete recovery without any sequelae. Conclusion. Risk factors for pediatric HZ are immunosuppression and chickenpox during the first year of life. Local trauma is a reported risk for VZV reactivation among adults. To our best knowledge, our case is the first reported pediatric case in which the injury of the left arm precedes HZ appearance. Routine vaccination against chickenpox may be an important preventive measure because herd immunity will protect infants and immunocompromised children from getting chickenpox and thus HZ.

2012 ◽  
Vol 16 (5) ◽  
pp. 368-371 ◽  
Author(s):  
Rachel A. Moquete ◽  
Barry Hartman ◽  
Richard D. Granstein

Background: Varicella-zoster virus is a member of the herpes virus family that causes varicella during a primary infection and herpes zoster (HZ) when reactivated. Patients who are immunocompromised often have atypical presentations of HZ and experience complications such as multidermal involvement and dissemination. Objective: We report a case of disseminated HZ in an immunocompetent patient with a history of splenectomy for idiopathic thrombocytopenic purpura (ITP). Our 46-year-old female patient presented with a painful vesiculopapular dermatomal rash with approximately 80 other lesions diffusely spread over her body. She was in good health but had a splenectomy for ITP 21 years earlier and a history of recurrent herpes labialis. The latter led to the tentative diagnosis of a widespread herpes simplex infection. However, laboratory results confirmed a diagnosis of disseminated herpes zoster. A workup of the patient's immune status did not reveal any abnormalities other than the patient's previously noted splenectomy. Conclusions: This case adds to the two reports of patients developing cutaneous disseminated HZ several years after splenectomy. Our case serves as a reminder that patients with a history of splenectomy appear to be at increased risk for cutaneous dissemination of HZ. Renseignements de base: Le virus varicelle-zona est un virus de la famille des Herpesviridae qui cause la varicelle durant une primo-infection, et l'herpès zoster (zona) (HZ) en cas de réactivation. Les patients qui sont immunocompromis ont souvent des présentations atypiques de HZ et affichent des complications telles que la participation et la dissémination multicutanées. Objectif: Nous exposons un cas de zona disséminé chez un patient immunocompétent ayant subi une splénectomie pour traiter un purpura thrombocytopénique idiopathique (PTI). Notre patiente âgée de 46 ans présentait une éruption vésiculo-papuleuse douloureuse localisée dans une zone dermatome avec environ 80 autres lésions diffuses réparties sur son corps. Elle était en bonne santé mais avait subi une splénectomie pour traiter un PTI 21 ans plus tôt et présentait des antécédents d'épisodes récurrents d'herpès labial. Ce dernier a abouti 'a un diagnostic provisoire d'une infection généralisée par le virus herpès simplex. Cependant, les résultats des analyses de laboratoire ont confirmé un diagnostic d'herpès zoster (zona) disséminé. Une investigation de l'état immunitaire de la patiente n'a pas révélé d'anomalies autres que la splénectomie que la patiente a subie antérieurement. Conclusions: Ce cas vient s'ajouter aux deux cas de patients signalés qui ont développé un HZ disséminé plusieurs années après avoir subi une splénectomie. Notre cas sert à rappeler que les patients présentant des antécédents de splénectomie semblent être exposés à un risque accru de dissémination cutanée sous forme de HZ.


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


2021 ◽  
Vol 34 (04) ◽  
pp. 307-310
Author(s):  
Yogeshwari Gupta ◽  
Khushbu Pandey

AbstractHerpes zoster (HZ), also known as shingles, occurs due to reactivation of varicella zoster. It is manifested by unilateral, painful, vesicular rashes following a dermatome. Homoeopathy is well known for its tremendous results in chronic cases. This article presents the evidence-based significant result of single homoeopathic remedy in an acute case of HZ within a short time period without any post-herpetic neuralgia which usually follows the HZ for months. Three to four doses of Hypericum 30 CH provided significant relief within a day and complete recovery within 10 days. Modified Naranjo score is 9, indicating definite causal attribution. This case proves that by selecting appropriate similimum, promising and positive results are achieved by homoeopathy, be it acute or chronic cases in a safe and gentle way. No such existing homoeopathic literature provides any characteristic information particularly related to HZ in Hypericum. So, future research and clinical trials could be beneficial for better validation of Hypericum as a therapeutic for HZ.


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.


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


2018 ◽  
pp. 93-98
Author(s):  
Jianguo Cheng

Herpes zoster is caused by reactivation of the latent varicella zoster virus (VZV) that causes chicken pox. VZV remains dormant in the dorsal root and cranial ganglia and can reactivate later in a person’s life and cause herpes zoster, which appears predominantly in older adults, but may also occur in those that are immunocompromised. Postherpetic neuralgia (PHN) is defined as pain in the affected dermatome that is still present 1 month after development of the vesicles. Adults older than 50 should receive the herpes zoster vaccine as part of routine medical care. Shingrix is a new vaccine recently approved and recommended by the FDA, which is a non-live, subunit vaccine. In contrast to Zostavax, Shingrix is 97% effective against shingles and 91% effective against PHN for people 50 and older. The diagnosis of herpes zoster can be made on the basis of characteristic skin lesions and pain and itching in the involved dermatome. During the acute phase, an antiviral given within 72 hours of onset helps reduce pain and complications and shorten the course of the disease. The diagnosis of PHN is based on a history of herpes zoster, typical dermatomal distribution of the pain, and hyperalgesia and/or allodynia on physical examination. First-line pharmacotherapy includes gabapentin or pregabalin, tricyclic antidepressants, and SNRIs. Combination therapies are often necessary. Interventional options such as epidural injections, paravertebral blocks, selective nerve root blocks, sympathetic nerve blocks, intercostal nerve blocks, trigeminal nerve blocks, spinal cord or dorsal root ganglion stimulation, and intrathecal therapy may be considered in refractory cases.


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

2015 ◽  
Vol 4 (4) ◽  
pp. 116-120
Author(s):  
Yuan Liu

AbstractHerpes zoster (HZ) is a varicella zoster virus (VZV) that attacks locality of nerves and skin, resulting information of clusters of blisters on the skin connected unilateral facial nerve and accompanying apparent nerve pain. Incidence ranges from 3.2 to 4.2 per 1000 populations per year in the United States. Influence factors of HZ include age, infection history with VZV, vaccination history of varicella vaccine, reduced immunocompetence, and other diseases. Current domestic studies on HZ mainly focus on clinical reports of case treatment. This study reviews advances in foreign epidemiological studies of HZ.


1996 ◽  
Vol 4 (4) ◽  
pp. 1-7
Author(s):  
Ariel A Waitzman ◽  
Peter C Neligan

Herpes zoster is a common infection caused by reactivation of the varicella zoster virus. In most patients the disease runs a painful but benign course with complete recovery. A unique case of trigeminal ophthalmic herpes zoster presented to The Toronto Hospital, Toronto, Ontario. This patient had a unilateral full thickness defect of scalp and skull with secondary osteomyelitis and opacification of the eye. After appropriate medical therapy and surgical debridement, reconstruction was undertaken using a latissimus dorsi free flap and split thickness skin grafts. This achieved a satisfactory reconstruction with obliteration of the diseased tissue. On follow-up several months later, there was erosion through the central area of the skin graft. This appears to be secondary to trauma caused by the patient frequently scratching the area, and that the original defect likely had a factitious component of the same etiology.


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