Disseminated Herpes Zoster

MERSELIS, JOHN G.

doi:10.1001/archinte.1964.00280110059012

Cited by 141 publications

(43 citation statements)

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“…During an illness that suppresses the immune system, the virus is reactivated and travels to the end of the nerve cell, where it causes the symptoms described above [1]. This complication of zoster has been described in immunocompromised persons (HIV, cancer, patients on immunosuppressive therapy) and reported to be as common as 10%-40% [3,4]. However, Herpes zoster oticus in otherwise healthy persons who are not on immunosuppressive therapy and have no underlying cancer is rare.…”

Section: Discussionmentioning

confidence: 99%

A rare case of Herpes zoster oticus in an immunocompetent patient

Dhavalshankh¹,

Dhavalshankh²,

Mhasvekar³

2012

Our Dermatol Online

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IntroductionRamsay Hunt syndrome (RHS) is first described by James Ramsay Hunt in 1907 [1]. It is caused by the reactivation of latent varicella-zoster virus (VZV) that has remained dormant within sensory root ganglia (commonly the geniculate ganglion) of the sensory branch of the facial nerve. Involvement of sensory branch of the geniculate ganglion of facial nerve leads Herpes zoster (HZ) oticus which is also known as RHS. Individuals with decreased cell-mediated immunity resulting from carcinoma, radiation therapy, chemotherapy or human immunodeficiency virus (HIV) infection are at greater risk for reactivation of latent VZV. Physical stress and emotional stress often are cited as precipitating factors. Incidence and clinical severity increases when host immunity is compromised. However it is uncommon to see Herpes zoster oticus in healthy individuals. In this report, we describe the clinical course of a patient who presented with Herpes zoster oticus in the absence of a known immunosuppressive condition. A brief review of literature on this topic is also presented. Case ReportA previously healthy 65-year old man presented with a 3-days history of vesicular lesions with erythematous base on neck. It was followed by the spread of vesicular eruption to involve external external auditory meatus of right side, and pinna over next 2-days. These are fluid filled vesicular eruptions which bust and break down on 2nd-3rd day with subsequent scab formation. There is no facial weakness. On examination, there was no lower motor neuron facial palsy. A neurologic examination revealed no weakness in the marginal mandibular branch of the left facial nerve. There is no any sign of loss of ipsilateral nasolabial fold or weakness in the temporal branch of the facial nerve. There were painful adherent crusts and scabs in left conchae and external auditory meatus (Fig. 1), associated with unclear hearing of left ear. The oral cavity and oropharynx were normal. Ocular examination demonstrated no nystagmus and normal conjunctiva. He has given history of stressful life events (sudden 3 deaths in family) in past 4 months. Review of systems was negative. The patient is not able to tell history of chickenpox during childhood or any recent exposure to it. There was no past history of diabetes, cardiac or pulmonary disease or lymphoma. The patient has not been on immunosuppressive or other medications. There is history of Psoriasis 2 years back showing on and off symptoms but on regular treatment. Patient is alcoholic, habit of tobacco chewing and occasional Pan chewing. On examination, the patient was afebrile (37.4°C). He had vesicles but not pustules, with crusting and swelling, in the distribution of the cervical division of VII (facial) cranial nerve. The left pinna is swollen, tender and red. There was no tympanic membrane involvement. Vesicles and scabs in various stages were also present lateral side of neck, in front of sternum and external ear ( Fig. 1) and behind Right pinna (Fig. 2) AbstractHerpes zoster oticus in healthy pe...

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Section: Discussionmentioning

confidence: 99%

A rare case of Herpes zoster oticus in an immunocompetent patient

Dhavalshankh¹,

Dhavalshankh²,

Mhasvekar³

2012

Our Dermatol Online

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“…Although this concern is largely theoretical, Merselis and colleagues 4 described a series of case reports in 1964 in which 17 of 175 patients developed disseminated herpes zoster. Five of the 17 patients were receiving corticosteroids or adrenocorticotropin hormone (ACfH).…”

Section: Safetymentioning

confidence: 99%

The Use of Corticosteroids in the Management of Herpes Zoster

MacFarlane

Simmons

Hunter

1998

The Journal of the American Board of Family Medicine

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(myocardial infarctions, pain, strokes, mortality, etc)-with the goal of offering patients the most practical, appropriate, and scientifically substantiated therapies. Whenever possible, number needed to treat to observe benefit in a single patient will also be included as a way of defining advantoges in terms that are relatively easy to understand. 5,6 At times this effort will be frustrating. Even as vast as theThe diagnosis of acute herpes zoster often introduces the issue of treatment with antiviral agents, with or without corticosteroids. Although there is evidence to support the use of antiviral agents (acy-

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“…These condi tions are sometimes induced by impaired host resistances , for example, delay of antibody response (Miller and Brunch 1970) or decline of local host defenses by x-ray irradiation (Guss et al 1971). Merselis et al (1964) reported that 11 of 17 patients with disseminated herpes zoster had serious underlying diseases. Nine of 11 patients with underlying diseases were receiving adrenocorticosteroids , x-ray therapy or radiomimetic drugs.…”

Section: Two Patientsmentioning

confidence: 99%

Virologic Studies of Generalized Herpes Zoster

Ikeda

Kimura

Shiono

et al. 1972

Tohoku J. Exp. Med.

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R. and NAKAO, T. Virologic Studies of Generalized Herpes Zoster. Tohoku J. exp. Med., 1972, 108 (1), 55-62 -Clinical and virologic studies of 2 cases with generalized herpes zoster were reported.The mechanism of varicelliform dissemination of zoster was thought to be as follows: one case was due to the immunodeficient state, but in the other case showing no abnormalities in immunoglobulins and antibody response the cause was not determined. varicella-zoster virus; varicelliform dissemination of zoster It was suggested first by von Bokay (1909) that varicella and herpes zoster were caused by the same agent. This concept was confirmed since W eller et al. (1958) and Weller and Witton (1958) isolated virus from patients with varicella or herpes zoster and found that these isolates were indistinguishable.The mechanism of varicelliform dissemination of zoster remains now obscure.In the present paper we shall report virologic studies on 2 cases with generalized herpes zoster. MATERIALS AND METHODS Two patientswith generalized herpes zoster who were admitted to our Hospital were investigated.Zoster vesicles were investigated by electron microscopic observations in. Case 1. Zoster vesicle fluids were collected for virus isolation on the 4th day after development of the rash in Case 2.Virus isolation was carried out by means of human embryo lung cells. VirusesVaricella-zoster virus (V-Z), the strain B-O, and CF antigen of herpes simplex virus were donated by

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Disseminated Herpes Zoster

Cited by 141 publications

References 11 publications

A rare case of Herpes zoster oticus in an immunocompetent patient

A rare case of Herpes zoster oticus in an immunocompetent patient

The Use of Corticosteroids in the Management of Herpes Zoster

Virologic Studies of Generalized Herpes Zoster

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