scholarly journals Herpes zoster ophthalmicus at a tertiary health facility, South-western Nigeria: Clinical presentations and outcome

2020 ◽  
Vol 6 (3) ◽  
pp. 333-337
Author(s):  
O Fasina ◽  
SJ Hughes
Keyword(s):  
Herpes Zoster ◽  
Health Facility ◽  
Trigeminal Nerve ◽  
Significant Proportion ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Clinical Presentations ◽  
Immunodeficiency Virus ◽  
Antiviral Medications ◽  
Type 3

Herpes zoster ophthalmicus is a neurocutaneous disease caused by the human alpha herpes virus Type 3 and it is characterized by reactivation of dormant varicella-zoster virus lying within the trigeminal ganglia. The objective of this study was to describe the clinical presentation and management outcome of patients with herpes zoster ophthalmicus in a tertiary health facility. This was a retrospective study of patients with herpes zoster ophthalmicus managed at the Eye Clinic of a tertiary health facility in the South-western part of Nigeria over eight years. There were 17 patients, comprising five males and the mean age at presentation was 54.9±13.7 years. Seven (41.2%) patients were seropositive for the Human Immunodeficiency Virus (HIV) while nine (52.9%) patients had corneal involvement. Fifteen (88.2%) patients had involvement of the first branch of the trigeminal nerve (V1), and one (5.9%) patient each had involvement of the second branch of the trigeminal nerve (V2) and the first two branches of the trigeminal nerve (V1 and V2). All the patients were managed with oral and topical antiviral medications. Ten patients (58.8%) developed postherpetic neuralgia. In conclusion, Herpes zoster ophthalmicus is strongly associated with HIV seropositivity and older age and a significant proportion of patients develop post-herpetic neuralgia necessitating long term management.

scholarly journals A Pediatric Case of Relapsing-Remitting Multiple Sclerosis Onset following Varicella Zoster Ophthalmicus with Optic Neuritis

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Naoko Shiba ◽  
Yuji Inaba ◽  
Mitsuo Motobayashi ◽  
Makoto Nishioka ◽  
Yoichiro Kawasaki ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Herpes Zoster ◽  
Optic Neuritis ◽  
Trigeminal Nerve ◽  
Present Report ◽  
Epidemiological Studies ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis

Some epidemiological studies have implied a pathogenetic association between varicella zoster virus (VZV) and multiple sclerosis (MS); this, however, remains controversial. The present report describes a case involving an immunocompetent 10-year-old girl who developed relapsing-remitting MS following the prolonged reactivation of VZV inside the first branch of the trigeminal nerve, exhibiting herpes zoster ophthalmicus with severe optic neuritis. Symptoms related to herpes zoster ophthalmicus and MS appeared consecutively in the 10-week period after the appearance of vesicles. This suggests that the onset of MS was triggered by some mechanism involving VZV reactivation in the first branch of the trigeminal nerve. To the best of our knowledge, this report is the first to describe a relationship between the onset of MS and herpes zoster ophthalmicus. Early diagnosis and aggressive antiviral therapy are important in cases of herpes zoster ophthalmicus to prevent the possible development of MS as well as visual impairment as sequela.

scholarly journals Hyponatremia: It’s in the Eye of the Beholder: Pitfalls in the Diagnosis and Treatment of SIADH with Desalination due to Herpes Zoster Ophthalmicus (HZO)

2021 ◽  
Vol 7 (2) ◽  
pp. 1-4
Author(s):  
Richard N Hellman ◽  
Keyword(s):  
Herpes Zoster ◽  
Trigeminal Nerve ◽  
Hormone Secretion ◽  
Diagnosis And Treatment ◽  
Herpes Zoster Ophthalmicus ◽  
Herpesvirus Type ◽  
Diuretic Hormone ◽  
Type 3

Herpes Zoster Ophthalmicus (HZO) is a rare cause of SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone secretion). It occurs when herpesvirus type 3 activation presents in the first division, or ophthalmic division of the trigeminal nerve.

scholarly journals Human immunodeficiency virus infection in a child presenting as herpes zoster ophthalmicus and non-healing keratitis

2017 ◽  
Vol 6 (4) ◽  
pp. 59-62
Author(s):  
M Chaudhary ◽  
R P Chaudhary
Keyword(s):  
Human Immunodeficiency Virus ◽  
Herpes Zoster ◽  
Sensory Nerves ◽  
Older Individuals ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Pediatric Age Group ◽  
Younger Age ◽  
Immunodeficiency Virus ◽  
The Right

Herpes Zoster is produced by reactivation of latent varicella zoster from the dorsal root ganglion of sensory nerves. It is common in older individuals and rarely described in Pediatric age group. Its occurrence in younger age should be viewed with suspicion. We describe an 11-year-old Nepali child who presented with herpes zoster ophthalmicus of right half of the forehead and a perforated corneal ulcer in the right eye. On investigations he was found to have been infected with human immunodeficiency virus (HIV). Patient responded well to systemic acyclovir. Thus, herpes zoster ophthalmicus in a young child should be viewed with suspicion. 

scholarly journals Herpes zoster of the trigeminal nerve with multi-dermatomal involvement: a case report of an unusual presentation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lorenzo Stefano Pelloni ◽  
Raffaele Pelloni ◽  
Luca Borradori
Keyword(s):  
Herpes Zoster ◽  
Varicella Zoster Virus ◽  
Trigeminal Nerve ◽  
Dna Amplification ◽  
Immunocompetent Patient ◽  
Varicella Zoster ◽  
Burning Pain ◽  
The Face ◽  
Patients At Risk ◽  
Trigeminal Nerves

Abstract Background Herpes zoster, also known as shingles, results from reactivation of the varicella-zoster virus. It commonly presents with burning pain and vesicular lesions with unilateral distribution and affects the thoracic and cervical sites in up to 60 and 20% of cases, respectively. The branches of the trigeminal nerves are affected in up to 20% of cases. Multidermatomal involvement of the trigeminal nerves has been only anecdotally described in immunocompetent subjects. Case presentation A 71-year-old previously healthy male presented with grouped vesicular and impetiginized lesions with crusts on the left half of the face of two-weeks duration. The lesions first developed on the left nasal tip and progressively worsened with unilateral appearance of vesicular lesions on the left forehead, face, ala nasi, nasal vestibulum and columella, as well as on the left side of hard and soft palate. The affected edematous erythematous areas corresponded to the distribution of the left ophthalmic (V1) and maxillary (V2) branches of the trigeminal nerve, including the infraorbital and nasopalatine nerves of the maxillary branch responsible for the oral cavity involvement. Viral DNA amplification by polymerase chain reaction confirmed the presence of Varicella zoster virus. The patient was started on oral valaciclovir with rapid recovery. Conclusions Among immunocompetent patients, herpes zoster is considered a self-limited localized infection. Our observation provides a rare but paradigmatic example of herpes zoster with involvement of both the ophthalmic and maxillary divisions of the trigeminal nerve in an immunocompetent patient. Immunocompetence status and age-specific screening should be warranted in case of atypical involvement and according to the patient’s history, while treatment with antiviral drugs should be rapidily initiated in patients at risk.

scholarly journals Does Herpes Zoster Increase the Risk of Stroke and Myocardial Infarction? A Comprehensive Review

2019 ◽  
Vol 8 (4) ◽  
pp. 547 ◽  
Author(s):  
Ping-Hsun Wu ◽  
Yun-Shiuan Chuang ◽  
Yi-Ting Lin
Keyword(s):  
Myocardial Infarction ◽  
Herpes Zoster ◽  
Antiviral Treatment ◽  
Cardiac Events ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Vesicular Rash ◽  
Ischemic Complications ◽  
One Year ◽  
Ischemic Attack

Herpes zoster (HZ) caused by varicella zoster virus (VZV) reactivation is characterized as a vesicular rash of unilateral distribution that can also cause multiple complications; such as post-herpetic neuralgia; ophthalmic zoster; and other neurological issues. VZV can also increase incident hemorrhagic or ischemic complications by causing inflammatory vasculopathy. Thus; emerging epidemiological and clinical data recognizes an association between HZ and subsequent acute strokes or myocardial infarction (MI). This study reviewed published articles to elucidate the association between HZ and cerebrovascular and cardiac events. Individuals exposed to HZ or herpes zoster ophthalmicus had 1.3 to 4-fold increased risks of cerebrovascular events. Higher risks were noted among younger patients (age < 40 years) within one year after an HZ episode. The elevated risk of CV events diminished gradually according to age and length of time after an HZ episode. The putative mechanisms of VZV vasculopathy were also discussed. Several studies showed that the development of herpes zoster and herpes zoster ophthalmicus increased the risks of stroke; transient ischemic attack; and acute cardiac events. The association between VZV infection and cardiovascular events requires further studies to establish the optimal antiviral treatment and zoster vaccination to reduce zoster-associated vascular risk

scholarly journals Effectiveness of Live Zoster Vaccine in Preventing Herpes Zoster Ophthalmicus (HZO)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S413-S413 ◽  
Author(s):  
Laurie Aukes ◽  
Joan Bartlett ◽  
Bruce Fireman ◽  
John Hansen ◽  
Edwin Lewis ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Cox Regression ◽  
Age Groups ◽  
Weighted Average ◽  
Care Seeking ◽  
Zoster Vaccine ◽  
Herpes Zoster Ophthalmicus ◽  
Varicella Zoster ◽  
Grant Recipient ◽  
Restricted Stock

Abstract Background Herpes zoster ophthalmicus (HZO), caused by reactivation of varicella-zoster virus in or around the eye, can be severe and often results in care-seeking that may be less discretionary than for uncomplicated herpes zoster (HZ). We compared the vaccine effectiveness (VE) of live zoster vaccine against HZO with the VE against HZ overall. Methods Kaiser Permanente Northern California (KPNC) members enter the ongoing cohort study when age-eligible for zoster vaccine starting in 2007. Incident HZ was defined as a new diagnosis of HZ with an antiviral prescription or a positive varicella viral test. Among those, an HZO case was defined as having an HZO diagnosis during an ophthalmology visit within 30 days of the initial HZ diagnosis. VE by age at vaccination and time since vaccination was estimated using Cox regression adjusted for age, race, sex and time-varying measures of healthcare use, comorbidities and immunocompromise status. Average VE over the first 5 years following vaccination was calculated as a weighted average of annual VE estimates. Results During 2007–2014, ~1.3 million individuals ≥50 years of age entered the study population and 29% were vaccinated. Among 48,889 incident HZ cases, 2,858 (6%) had HZO, 87% of whom were unvaccinated. For all ages combined, VE against HZO was 72% (95% CI, 64%-79%) in year 1, similar to 68% (95% CI, 65%-70%) against HZ. VE fell in years 2, 3, 4, and 5 to 47%, 45%, 42% and 27% for HZO and to 47%, 39%, 41% and 37% for HZ. For age groups 60 – 69 and 70 – 79, where we have the most data, initial VE and waning were similar for HZO and HZ. Numbers of HZO cases for 50–59 year olds were too small to evaluate at this time. Average VE against HZO over the first 5 years following vaccination was 52% (95% CI, 42%–60%) for ages 60–69, 51% (95% CI, 39%–61%) for ages 70-79, and 39% (95% CI, 14%-57%) for ages 80+; similarly, 5-year average VE against HZ was 49%, 46%, and 44% for these 3 age groups. Conclusion VE against HZO was similar to VE against HZ regardless of age at vaccination or time since vaccination. Effectiveness of live zoster vaccine in preventing HZO was highest in year one with subsequent waning. Disclosures E. Earley, Merck & Co.: Research Contractor, Salary; M. Marks, Merck and Co. Inc.: Employee, Restricted Stock and Salary; P. Saddier, Merck & Co., Inc.: Employee, Salary; N. P. Klein, GSK: Investigator, Grant recipient; sanofi pasteur: Investigator, Grant recipient; Merck & Co.: Investigator, Grant recipient; MedImmune: Investigator, Grant recipient; Protein Science: Investigator, Grant recipient Pfizer: Investigator, Grant recipient

Herpes Zoster Ophthalmicus—Diagnosis and Management

2013 ◽  
Vol 06 (02) ◽  
pp. 1 ◽  
Author(s):  
Antoine Rousseau ◽  
Tristan Bourcier ◽  
Joseph Colin ◽  
Marc Labetoulle ◽  
◽  
...  
Keyword(s):  
Herpes Zoster ◽  
General Population ◽  
Viral Replication ◽  
Varicella Zoster Virus ◽  
Lifetime Risk ◽  
Herpes Zoster Ophthalmicus ◽  
Ocular Complications ◽  
Varicella Zoster ◽  
Diagnosis And Management

Varicella-zoster virus (VZV) infections are widely distributed in the general population. The lifetime risk of herpes zoster is estimated to be 10–20 %, increasing with age (1–4). Since herpes zoster ophthalmicus (HZO) accounts for 20 % of all locations of shingles, the lifetime risk of HZO is about 1–2 %. The management of ocular complications of VZV infection is now well codified, but sequellae still can occur, despite an armamentarium effective in limiting viral replication and its immune consequences.

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