scholarly journals Comparison of Intrathecal Concentrations of Acyclovir following Epidural and Intravenous Administration in Rats

2016 ◽  
Vol 4;19 (4;5) ◽  
pp. E613-E619
Author(s):  
Sang Sik Choi
Keyword(s):  
Herpes Zoster ◽  
Varicella Zoster Virus ◽  
Plasma Concentrations ◽  
Cranial Nerves ◽  
Group Iv ◽  
Epidural Administration ◽  
Varicella Zoster ◽  
Drug Concentrations ◽  
Median Plasma ◽  
Intrathecal Space

Background: Herpes zoster is a disease caused by reactivation of varicella-zoster virus in sensory cranial nerves and dorsal root ganglion. Our presumption was that epidural administration of acyclovir near the viral burden could be more advantageous than intravenous (IV) administration. The cerebrospinal fluid (CSF) concentration of acyclovir after epidural administration was determined to be higher than that after IV administration in rats. Objective: In this study, we tested the hypothesis that the concentration of acyclovir in CSF after epidural administration is higher than that achieved after IV administration in rats. Study Design: A randomized controlled animal trial. Methods: A total of 30 adult male Sprague-Dawley rats were used. The rats were randomly divided into 2 equal groups, epidural (Group Epi) and IV (Group IV) administration groups (n = 15). Group Epi was further subdivided into 3 groups according to acyclovir dosage; each group comprised 5 animals receiving injections at dosages of 0.3 mg, 0.6 mg, and 0.9 mg. Group IV was also subdivided into 3 groups receiving dosages of 3 mg, 6 mg, and 9 mg. We measured CSF and plasma acyclovir concentrations one hour after administration. Results: In Group Epi, the median plasma concentrations of acyclovir were lower than that in CSF (P < 0.05). In Group IV, the median plasma concentrations of acyclovir were significantly higher than that in CSF (P < 0.05). The CSF concentrations of acyclovir in Group Epi were significantly higher than that in Group IV (P < 0.05). The plasma concentrations of acyclovir in Group Epi were significantly lower than that in Group IV (P < 0.05). Limitations: There were no references of equivalent dosages of acyclovir between IV and epidural administration. However, it is obvious in this study that epidural administration of a low dose of acyclovir can more effectively increase its concentration in the intrathecal space than IV administration. Conclusions: Epidural administration of acyclovir provides superior drug concentrations in the intrathecal space compared to IV administration. Key words: Acyclovir, epidural injection, herpes zoster, varicella zoster virus

scholarly journals Varicella Zoster Virus-Associated Meningitis as a Rebound Varicella Zoster Disease after Antiviral Discontinuation

2021 ◽  
pp. 148-153
Author(s):  
Tetsuko Sato ◽  
Takenobu Yamamoto ◽  
Yumi Aoyama
Keyword(s):  
Herpes Zoster ◽  
Early Diagnosis ◽  
Varicella Zoster Virus ◽  
Immunosuppressive Therapy ◽  
Unusual Case ◽  
Cranial Nerves ◽  
Skin Lesions ◽  
Immunocompromised Patients ◽  
Aggressive Treatment ◽  
Varicella Zoster

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.

scholarly journals A rare case of herpes zoster maxillaris with cranial polyneuropathy

2017 ◽  
Vol 4 (1) ◽  
pp. 290
Author(s):  
Shubhransu Patro ◽  
Debananda Sahoo ◽  
Anil Kumar Dash ◽  
Biswamohan Mishra
Keyword(s):  
Herpes Zoster ◽  
Facial Nerve ◽  
Varicella Zoster Virus ◽  
Rare Case ◽  
Rare Complication ◽  
Cranial Nerves ◽  
Occurrence Rate ◽  
Varicella Zoster ◽  
High Affinity ◽  
Cranial Nerve Palsies

Varicella zoster virus has a high affinity for the ganglion and causes various neuropathies. About 12% of all peripheral facial nerve palsies are caused by varicella zoster virus, a rare complication due to reactivation of the herpes zoster virus in the geniculate ganglion of facial nerve. The occurrence rate of associated cranial polyneuropathy has been reported to be 1.8-3.2% and cranial nerves VII, VIII, IX and X are the ones most commonly affected. Here, we present a case of Herpes zoster maxillaris with cranial polyneuropathy who was improved with oral anti-viral drugs and steroid. Multiple cranial nerve palsies are being observed frequently in patients who were referred with a preliminary diagnosis of facial palsy. These patients are required to be examined in detail for involvement of other cranial nerves. Early diagnosis and treatment is required for reversing the functions of cranial nerves and decreasing the chance of developing other complications.

Oral manifestations of infections due to varicella zoster virus in otherwise healthy children

2002 ◽  
Vol 25 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Alexandros Kolokotronis ◽  
Konstantinos Louloudiadis ◽  
Garyfalia Fotiou ◽  
Apostolos Matiais
Keyword(s):  
Herpes Zoster ◽  
Varicella Zoster Virus ◽  
Cranial Nerves ◽  
Differential Diagnostics ◽  
Oral Lesions ◽  
Healthy Children ◽  
Oral Manifestations ◽  
Normal Children ◽  
Varicella Zoster ◽  
Group B

Varicella zoster virus (VZV) causes varicella (or chickenpox) and establishes latency in nerve ganglia after the primary infection. The reactivation of virus later in life can cause mono- or polyneuropathy. The cranial nerves most commonly involved are five (herpes zoster or shingles), six, seven eight, nine and ten. In the present study we describe the oral lesions associated with VZV infections in normal children. In a 3 year period we examined 62 children, age 2 to 13 years old with diagnosed varicella and a 4 year old boy with herpes zoster at the 3rd branch of the trigeminal nerve. According to the clinical picture of varicella, the disease was defined as: (1) group A mild cases; (2) group B moderate cases; (3) group C severe. The manifestations of varicella were: mild varicella 19 children, moderate 26 children and severe 17 children. The results of the present study indicate that the prevalence of oral manifestations of varicella is related to the severity of the disease. In 17 severe cases, oral lesions were always present and the number was between 5 to 30. From 26 moderate cases, oral lesions were observed in 23 and the number was between 2 to 10. From 19 mild cases, oral lesions were present only in 6 cases and their number was 1 or 2. Often varicella's oral lesions resemble manifestations of other entities, and this may cause differential diagnostics problems.

scholarly journals Herpes zoster recurrence within 1 month: A case report

2021 ◽  
Vol 19 ◽  
pp. 205873922110212
Author(s):  
Nan Zhao ◽  
Yulan Geng ◽  
Yexian Li ◽  
Lijuan Liu ◽  
Yanjia Li ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Case Report ◽  
Herpes Zoster ◽  
B Cells ◽  
Varicella Zoster Virus ◽  
Lower Limit ◽  
Skin Disease ◽  
Clinical Manifestations ◽  
Varicella Zoster ◽  
Humoral Immune

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.

scholarly journals Incidence of herpes zoster and seroprevalence of varicella-zoster virus in young adults of South Korea

2008 ◽  
Vol 12 (3) ◽  
pp. 245-247 ◽  
Author(s):  
Cheol-In Kang ◽  
Chang-Min Choi ◽  
Tae-Sung Park ◽  
Dong-Jun Lee ◽  
Myoung-don Oh ◽  
...  
Keyword(s):  
Young Adults ◽  
Herpes Zoster ◽  
South Korea ◽  
Varicella Zoster Virus ◽  
Varicella Zoster

scholarly journals Herpes Zoster involving Trigeminal Nerve

2012 ◽  
Vol 2 (1) ◽  
pp. 50-52
Author(s):  
Rohit B Gadda ◽  
Neha Patil ◽  
Rohini Salvi
Keyword(s):  
Quality Of Life ◽  
Herpes Zoster ◽  
Viral Infection ◽  
Varicella Zoster Virus ◽  
Acute Pain ◽  
Healthy Male ◽  
Prodromal Symptoms ◽  
Varicella Zoster ◽  
Acute Viral Infection

Abstract Herpes zoster is a common acute viral infection caused by reactivation of Varicella-Zoster virus. Acute pain of herpes zoster lowers the quality of life and interferes with day to day activities. We report a case of herpes zoster in a 68 year old, healthy male patient in which the prodromal symptoms started as toothache. This case highlights the importance of a thorough dental history and examination in patients with toothache.

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