Disseminated Herpes Zoster in an Immunocompetent Elderly Patient

The inclusion criteria were age >17 years, previous examination by a dermatologist, fulfillment of the clinical criteria for DHZ, and virological confirmation by detection of the antigen using direct immunofluorescence or polymerase chain reaction (PCR) based on a swab sample of the vesicles. However, within a week of cessation of therapy, the patient re-presented with dermatomal zoster and meningoencephalitis. Two days later, cutaneous lesions of varicella appeared all over and the patient developed increased bilateral orbital edema. erpes zoster is a characteristic dermatomal maculo- vesicular rash that results from reactivation of varicella-zoster virus (VZV). At the time of the hospital visit, the visual analogue scale was 7/10, so the patient was hospitalized. In contrast, patients with T-cell deficiency, such as HIV patients and bone marrow transplant recipients, can present with severe cutaneous and visceral disseminated disease.1 Cutaneous dissemination of HZ among immunocompetent hosts has been previously reported in the literature mainly as a single case reports or small case series. Population-based study of herpes zoster and its sequelae.

Hydrocortisone injection is in a class of medications called corticosteroids. Herpes zoster is a cutaneous infection that is characterized by an acute vesicobullous rash with ipsilateral one or two dermatomal distribution and painful allodynia, while predominantly being found in the elderly. One patient was treated with azidothymidine, and typical dermatomal herpes zoster subsequently developed. How to cite this article Kennedy RE, Dhanoa N, Frey K. However, within a week of cessation of therapy, the patient re-presented with dermatomal zoster and meningoencephalitis. The next day, grouped vesicles, including hemorrhagic vesicles erupted on the right side of the second to third cervical (C2-C3) dermatomes. Grouped vesicles, each quite typical of a solitary chickenpox vesicle, develop in that dermatome.


Moreover, B cell counts repopulated before DMF was initiated. Patients median age were 40 (21-67) years old and 12 (55%) were male. It is regarded as a hypersensitivity disorder which is triggered by multiple factors such as infection, drugs and food [1,2]. An 83-year-old African-American female with RA presented with generalized and widespread vesicular rash covering her entire body. Recently, we read with interest two articles published in Endoscopy. Erythema multiforme (EM) is a vesiculobullous disorder with variable manifestations that predominantly affects the skin. The incidence of herpes zoster increases with age and immunosuppression, therefore prompt management is necessary to avoid morbidity and mortality in these individuals.

Objective  To estimate the seroprevalence of VZV in the Brazilian pediatric population by evaluating the prevalence of specific antibodies to VZV in children from two university hospitals in the state of Rio de Janeiro. The classical presentation of zoster is a painful or pruritic unilateral vesicular eruption with a dermatomal distribution. Among those who survived for 2 or more years after transplantation (n = 47), 59% developed VZV infection. Providing treatment of the disease within 72 hours of rash onset will result in a more rapid resolution of cutaneous lesions and decrease viral shedding, but will not change the incidence of postherpetic neuralgia. The occurrence and clinical characteristics of all episodes of herpes zoster were recorded. Median time of diagnosis of Varicella zoster virus was 5 years after transplant (range, 3 mo to 13 y). Moreover, B cell counts repopulated before DMF was initiated.

Dissemination of zoster, however, directly resulted in only one death. She had no history of viral reactivation or opportunistic infections (OIs) and had not had immunotherapy for more than a year before commencing DMF. About 10 days before his presentation, he developed dermatomal herpes zoster infection over the left side of the chest and back, which was successfully treated with a standard regimen of oral acyclovir. Less commonly, the rash can be more widespread and affect three or more dermatomes. Unlike many other STDs, Herpes lesions are usually painful, sore, or tender to the touch. The present study reports the cases of 3 patients with Disseminated and visceral VZV infection undergoing treatment for follicular lymphoma, Diffuse large B-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified [5]. Extensive cutaneous dissemination has been reported in immune-compromised patients, such as those who suffer from HIV infections, cancer, chemotherapy, and corticosteroid therapy patients.

Herpes zoster represents reactivation of varicella zoster virus from cranial nerve or dorsal root ganglia, thus affecting the skin in a dermatomal distribution. A 44 year-old Japanese male, who had been in the hospital with acute myelocytic leukemia, developed disseminated hemorrhagic vesicles of 5 to 10 mm in diameter. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Post herpetic neuralgia, the most common complication could develop persisting during months or even years. On examination, vesicles, umbilicated pustules, and crusted lesions were noted on the face, trunk, and limbs (Figures 1 and 2). In individuals with damaged immune systems, herpes zoster may be widespread (disseminated), causing serious illness. In individuals with damaged immune systems, herpes zoster may be widespread (disseminated), causing serious illness.

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