Herpes zoster-encefalitis: een diagnostische uitdaging bij de geriatrische patiënt

2022 ◽  
Author(s):  
L. Carmans ◽  
C. Van Dessel
Keyword(s):  
Herpes Zoster ◽  
Rare Complication ◽  
Diagnostic Process ◽  
Herpes Encephalitis ◽  
Diagnostic Challenge ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Prevalent Disease ◽  
Vesicular Rash

Herpes zoster encephalitis: a diagnostic challenge in a geriatric patient Reactivation of the varicella zoster virus (VZV) is a prevalent disease and is - in addition to the typical vesicular rash - responsible for rare neurological conditions. Older people form a major group of concern, given the increasing risk of VZV reactivation at a higher age together with a higher risk of complications. Herpes zoster encephalitis is a rare but serious complication which often presents atypically, delaying the diagnostic process. In this article, the medical history of a patient with herpes encephalitis without the typical clinical and biochemical signs of infection is presented. This patient also suffered from Ramsay Hunt syndrome, another rare complication of VZV, characterized by vesicular rash in the ear and ipsilateral peripheral facial paralysis. Both diseases are briefly reviewed and the potential benefits of vaccination are discussed.

scholarly journals Ramsay hunt syndrome- expect the unexpected: A case report

2021 ◽  
Vol 7 (3) ◽  
pp. 172-175
Author(s):  
Poorva Saxena ◽  
G. V. Ramachandra Reddy ◽  
Hina Handa ◽  
Ajita Singh
Keyword(s):  
Case Report ◽  
Herpes Zoster ◽  
Neurological Diseases ◽  
Rare Complication ◽  
Varicella Zoster Virus Infection ◽  
Post Herpetic Neuralgia ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Vesicular Rash

Herpes zoster represents a latent reactivation of the varicella zoster virus infection with a dermatomal pattern of eruption and complicated by post-herpetic neuralgia. Ramsay hunt syndrome is a rare complication of herpes zoster and it is not just a syndrome but it's rather an infectious disease. This syndrome is characterized by peripheral facial nerve palsy associated with an erythematous vesicular rash on the ear. It is characterized by unilateral pattern of facial involvement and presence of vesicles helps in early diagnosis and distinguish the syndrome with diseases mimicking other severe neurological diseases. This article reports a case of 56-year-old male patient who reported with a complaint of severe toothache, which serves as severe prodrome for reactivation of herpes zoster virus which later leads to Ramsay Hunt syndrome. This case report highlights about the management of herpes zoster and its complication and emphasizes on prevention of post herpetic neuralgia complication.

scholarly journals Ramsay hunt syndrome- expect the unexpected: A case report

2021 ◽  
Vol 7 (3) ◽  
pp. 172-175
Author(s):  
Poorva Saxena ◽  
G. V. Ramachandra Reddy ◽  
Hina Handa ◽  
Ajita Singh
Keyword(s):  
Case Report ◽  
Herpes Zoster ◽  
Neurological Diseases ◽  
Rare Complication ◽  
Varicella Zoster Virus Infection ◽  
Post Herpetic Neuralgia ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Vesicular Rash

Herpes zoster represents a latent reactivation of the varicella zoster virus infection with a dermatomal pattern of eruption and complicated by post-herpetic neuralgia. Ramsay hunt syndrome is a rare complication of herpes zoster and it is not just a syndrome but it's rather an infectious disease. This syndrome is characterized by peripheral facial nerve palsy associated with an erythematous vesicular rash on the ear. It is characterized by unilateral pattern of facial involvement and presence of vesicles helps in early diagnosis and distinguish the syndrome with diseases mimicking other severe neurological diseases. This article reports a case of 56-year-old male patient who reported with a complaint of severe toothache, which serves as severe prodrome for reactivation of herpes zoster virus which later leads to Ramsay Hunt syndrome. This case report highlights about the management of herpes zoster and its complication and emphasizes on prevention of post herpetic neuralgia complication.

scholarly journals Facial paralysis due to Ramsay Hunt syndrome - A rare condition

2017 ◽  
Vol 63 (4) ◽  
pp. 301-302 ◽  
Author(s):  
Aline Lariessy Campos Paiva ◽  
João Luiz Vitorino Araujo ◽  
Vinicius Ricieri Ferraz ◽  
José Carlos Esteves Veiga
Keyword(s):  
Herpes Zoster ◽  
Facial Paralysis ◽  
Rare Complication ◽  
Rare Condition ◽  
Varicella Zoster Virus Infection ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Condition Diagnosis ◽  
Symptoms And Signs

Summary Ramsay Hunt syndrome (or herpes zoster oticus) is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion occurs. Usually, there are auricular vesicles and symptoms and signs such otalgia and peripheral facial paralysis. In addition, rarely, a rash around the mouth can be seen. Immunodeficient patients are more susceptible to this condition. Diagnosis is essentially based on symptoms. We report the case of a diabetic female patient who sought the emergency department with a complaint of this rare entity.

scholarly journals Ramsay Hunt Syndrome in a Patient with Ulcerative Colitis Treated with Infliximab

2021 ◽  
Author(s):  
Margarida Gaudencio ◽  
Maria Inês Bertão ◽  
André Carvalho ◽  
Gabriela Pena ◽  
Isabel Bessa ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Herpes Zoster ◽  
Varicella Zoster Virus ◽  
Cranial Nerve ◽  
Rare Complication ◽  
Geniculate Ganglion ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome

Ramsay Hunt syndrome is a rare complication of herpes zoster that results from reactivation of varicella-zoster virus in the geniculate ganglion of the VII cranial nerve. Immunosuppression can lead to reactivation of latent varicella-zoster virus, resulting in herpes zoster. Here, we present a case of Ramsay Hunt syndrome in a patient with ulcerative colitis under treatment with infliximab.

scholarly journals Herpes Zoster Otikus Dengan Paresis Nervus Fasialis (Sindrom Ramsay Hunt) Pada Pasien Imunokompromais

2020 ◽  
Vol 7 (1) ◽  
pp. 113-118
Author(s):  
Holy Ametati ◽  
Hayra Diah Avianggi
Keyword(s):  
Herpes Zoster ◽  
Facial Nerve ◽  
Rare Complication ◽  
Left Chest ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Herpes Zoster Oticus ◽  
Hunt Syndrome ◽  
Zoster Sine Herpete ◽  
Nerve Paresis

Latar belakang: Sindrom Ramsay Hunt (SRH) merupakan komplikasi yang jarang terjadi pada herpes zoster. SRH dapat terjadi tanpa adanya ruam kulit (zoster sine herpete). Karena gejala-gejala ini tidak selalu muncul saat onset, sindrom ini sering salah didiagnosis. Insidensi 5/100.000 kasus pada populasi di Amerika Serikat dan meningkat pada kelompok umur di atas 60 tahun dan kondisi imunokompromais. Laporan Kasus: Laki-laki, 66 tahun, timbul plenting-plenting di daerah telinga kiri menyebar ke dada sebelah kiri sejak 8 hari sebelum dikonsulkan. Terdapat nyeri pada telinga, pendengaran berkurang, pusing berputar, wajah sebelah kiri sulit digerakkan dan sulit berbicara. Permeriksaan fisik ditemukan vesikel berkelompok dengan dasar kulit eritem dan edema, bula, erosi, krusta, konfigurasi herpetiformis, distribusi unilateral, segmental setinggi persarafan servikal 2-4. Temuan tzank test menunjukkan sel datia berinti banyak. Penatalaksanaan dengan sistemik asiklovir dan metilprednison. Pembahasan: SRH merupakan hasil reaktivasi virus varicella zoster laten diganglion genikulatum yang menyebabkan vesikel pada aurikula, otalgia dan paresis/paralisis fasialis. Mekanisme pencetus reaktivasi pada pasien ini diduga berhubungan dengan imunokompromais (keganasan). Pasien imunokompromais memiliki resiko 20-100 kali lebih besar. Pemeriksaan Tzank sesuai dengan gambaran herpes zoster. Terapi SRH yang paling disarankan adalah terapi kombinasi antivirus dan kortikosteroid. Kesimpulan: Telah dilaporkan kasus herpes zoster otikus dengan paresis nervus fasialis (Sindrom Ramsay Hunt) pada pasien imunokompromais. Hasil terapi memuaskan. Prognosis qua ad vitam ad bonam, ad sanam dubia ad malam, ad cosmeticam dubia ad bonam. Kata kunci: Sindrom Ramsay Hunt, Herpes Zoster Otikus, Paresis Nervus Fasialis, Immunokopromais.   Background; Ramsay Hunt Syndrome (RHS) is a rare complication in shingles. RHS can occur without the presence of skin rash (zoster sine herpete). Because these symptoms do not always appear at onset, RHS is often misdiagnosed. The incidence of 5/100,000 cases in the US and increase in the age above 60 years and immunocompromised. Case: A 66-years-old male complaint of vesicle on the left ear spreading to left chest, since                  8 days prior to the consultation. There was otalgia, dizziness, hearing impairment, difficulty in movement and speaking on the left side. Physical examination found clustered vesicle on an erythematosus and oedematous base, bullaes, erosions, crusts, in a herpetiformis configuration, unilateral distribution, in a level of 2-4 cervical nerve innervation. The Tzank test showed multinucleated giant cells. Management with systemic acyclovir and methylprednisolone. Discussion: RHS is the result of reactivation of latent varicella zoster virus in geniculate ganglion which causes vesicles in the auricle, otalgia and facial paresis / paralysis. The mechanism for triggering reactivation in these patients is immunocompromise (malignancy). Immunocompromised have a 20-100 times greater risk. Tzank results in accordance with diagnostic of herpes zoster. The most recommended therapy is combination of antiviral and corticosteroid. Conclusion: The case of herpes zoster oticus with facial nerve paresis (Ramsay Hunt Syndrome) in immunocompromised has been published. The result of therapy was satisfying. The prognosis qua ad vitam ad bonam, ad sanam dubia ad malam, ad cosmetics dubia ad bonam. Keywords: Ramsay Hunt Syndrome, Herpes Zoster Oticus, Facial Nerve Paresis, Immunokopromised.

scholarly journals Ramsay Hunt syndrome with facial vesicular rash: a unique clinical presentation in a kidney transplant patient

2014 ◽  
Vol 8 (07) ◽  
pp. 923-924 ◽  
Author(s):  
Carlos Abaeté De los Santos ◽  
Ivan Carlos Ferreira Antonello ◽  
Vicente Sperb Antonello ◽  
Florência Barreiro
Keyword(s):  
Hearing Loss ◽  
Herpes Zoster ◽  
Kidney Transplant ◽  
Kidney Transplant Patient ◽  
Virus Reactivation ◽  
Ramsay Hunt Syndrome ◽  
Transplant Patients ◽  
Hunt Syndrome ◽  
Vesicular Rash ◽  
The Face

Ramsay Hunt Syndrome (RHS) is the result of herpes zoster virus reactivation producing hearing loss, pain and vesicles in the ear or mouth, along with ipsilateral facial palsy due to the 7th cranial nerve geniculate ganglion infectious involvement. This condition has not been previously described, particularly in transplant patients. A 38-year old man underwent kidney transplantation and two years later experienced an ache on the left side of the face and hearing loss in the ear, also exhibiting vesicular lesions and concomitant facial peripheral palsy. Acyclovir IV was initiated, and the prednisone dose was increased. The patient was discharged 15 days later, feeling better but still exhibiting dark spots on his face. At three months follow-up he was asymptomatic, showing notable palsy improvement. Until this case, herpes zoster facial lesions causing typical RHS have never been reported in literature, particularly in kidney transplant patients.

scholarly journals A Rare Case of Cranial Polyneuritis as Complication of Ramsay Hunt Syndrome

2019 ◽  
Vol 11 (4) ◽  
pp. 133-136
Author(s):  
Jonathan Kurnia Wijaya ◽  
Hendra Wijaya Wong
Keyword(s):  
Case Report ◽  
Facial Paralysis ◽  
Rare Complication ◽  
Severe Disease ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Delayed Treatment ◽  
Hunt Syndrome ◽  
Classic Triad ◽  
Initial Symptoms

AbstractRamsay Hunt Sydnrome is a rare and severe disease caused by the reactivation of varicella zoster virus (VZV) in the ganglia geniculate. The classic triad of this disease includes ear pain (otalgia), vesicles in the auditory canal, and facial paralysis. This case report is about a 37-year-old woman that has the classic triad of Ramsay Hunt Syndrome, as well as a rare complication of cranial polyneuritis in the form of cephalgia and vertigo which occurs only in 1.8% of cases. The patient came one week after the initial symptoms had started and was given antiviral combination therapy and steroids. Treatment of this disease is time sensitive to <72 hours and will determine the prognosis. One month later the follow up showed sequelae in the form of persistent headache and slight facial paralysis as a result of delayed treatment. This case report showed the importance of prompt diagnosis and treatment to minimize complications of Ramsay Hunt Syndrome.

scholarly journals Case Report: When Shingles Disrupts Bladder Function

2020 ◽  
Vol 3 (1) ◽  
pp. 95-97
Author(s):  
Aaron Campeas ◽  
◽  
Eric J. Basile ◽  
◽  
◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Dorsal Root ◽  
Rare Complication ◽  
Bladder Function ◽  
Buttock Pain ◽  
Varicella Zoster ◽  
Chicken Pox ◽  
Double Stranded Dna ◽  
Left Buttock ◽  
Vesicular Rash

Varicella Zoster (shingles) virus is a double stranded DNA in the Herpesviridae family that can present as both chicken pox and as shingles. The virus enters through the respiratory system, replicating in the nasopharynx, and causes a viremia upon primary infection. Varicella Zoster spreads to other organs and often lies dormant in the dorsal root ganglion. Reactivation of the virus is more common in older or immunocompromised patients and often presents as a painful vesicular rash in a unilateral dermatomal distribution with possible concurrent radiculopathy. A rare complication of herpes zoster is urinary dysfunction. We report a case of a 42-year-old patient diagnosed with herpes zoster whose primary complaint was left buttock pain and a maculovesicular rash in the S2-S4 dermatomal distribution. She was prescribed Valacyclovir and began to experience urinary retention two days after starting the medication.

scholarly journals Ramsay Hunt syndrome presenting as simple otitis externa

CJEM ◽  
2008 ◽  
Vol 10 (03) ◽  
pp. 247-250 ◽  
Author(s):  
Daniel Kim ◽  
Munsif Bhimani
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
Rare Complication ◽  
Varicella Zoster Virus Infection ◽  
Facial Weakness ◽  
Peripheral Facial Paralysis ◽  
Varicella Zoster ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
History Of

ABSTRACTRamsay Hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection occurs in the geniculate ganglion, causing otalgia, auricular vesicles and peripheral facial paralysis. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. We report the case of a patient who was diagnosed with simple otitis externa after presenting to the emergency department (ED) with a 3-day history of right-sided otalgia. Her condition subsequently evolved to include right-sided auricular vesicles and right-sided facial weakness. She presented to the ED again after 2 days and was correctly diagnosed with Ramsay Hunt syndrome. We describe the clinical presentation, diagnostic findings and management of this uncommon but important entity.

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