Ogilvie Syndrome and Herpes Zoster: Case Report and Review of the Literature

Edelman, David A.; Antaki, Fadi; Basson, Marc D.; Salwen, Walter A.; Gruber, Scott A.; Losanoff, Julian E.

doi:10.1016/j.jemermed.2009.02.010

Cited by 44 publications

(39 citation statements)

References 20 publications

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“…The present case illustrates that acute colonic pseudo-obstruction (Ogilvie's syndrome) can be produced by VZV infection and that it usually occurs in immunocompromised persons (4,(9)(10)(11)(12)(13)(14)(15)(16)(17). VZV-induced Ogilvie's syndrome carries significant rates of morbidity and mortality, and its diagnosis requires a high index of suspicion because visceral symptomatology may antecede the appearance of the characteristic skin eruption (11,14).…”

Section: Case Reportmentioning

confidence: 90%

“…VZV-induced Ogilvie's syndrome carries significant rates of morbidity and mortality, and its diagnosis requires a high index of suspicion because visceral symptomatology may antecede the appearance of the characteristic skin eruption (11,14). However, the coexistence of herpes zoster and Ogilvie's syndrome is uncommon and has received scant attention in the medical literature.…”

Section: Case Reportmentioning

confidence: 99%

“…However, the coexistence of herpes zoster and Ogilvie's syndrome is uncommon and has received scant attention in the medical literature. The largest case series published on this association involved 29 patients from 21 studies (1950 to 2008) (11). That review included 22 men and 7 women aged 32 to 87 years, relevant comorbidities being present in 45% of cases (malignancies in 8 [28%] patients).…”

Section: Case Reportmentioning

confidence: 99%

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Varicella-Zoster Virus (VZV) Infection as a Possible Cause of Ogilvie's Syndrome in an Immunocompromised Host

Carrascosa¹,

Salcines-Caviedes²,

Gómez-Román

et al. 2014

J Clin Microbiol

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We describe an immunodeficient adult with Ogilvie's syndrome preceding a disseminated papulovesicular skin rash in whom varicella-zoster virus infection was demonstrated by PCR assay in cutaneous and colonic biopsy specimens. In view of the significant morbidity and mortality that this condition carries, early and accurate molecular diagnosis and timely treatment are strongly recommended. CASE REPORTA 62-year-old white man was admitted in June 2013 because of a 6-day history of severe and worsening abdominal pain and vomiting. He had been diagnosed with stage IIIA, diffuse large B-cell lymphoma in 2004, when complete remission was achieved following immunochemotherapy (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone [R-CHOP]). In 2008, he received immunochemotherapy as a salvage treatment for relapse (rituximab, etoposide, cytarabine, cisplatinum, and methylprednisolone [R-ESHAP]) and an autologous hematopoietic stem-cell transplant, reaching complete remission once more. Afterwards, the patient was given consolidation chemotherapy until October 2012, bendamustine being the last agent prescribed. A positron emission tomography scan performed in May 2013 displayed normal findings. His medical history also included diabetes mellitus and an episode of herpes zoster on the right T 12 dermatome 15 months before admission. He denied opiate, phenothiazines, or calcium channel blocker administration, chronic constipation, or recent trauma or surgical intervention. He was not on immunosuppressive therapy.On admission, the patient was afebrile and hemodynamically stable. Physical examination revealed profound abdominal distention and decreased bowel sounds but no signs of peritoneal irritation. Blood tests were significant for leucopenia and lymphopenia (2.3 ϫ 10 9 /liter leukocytes, 71.4% neutrophils, 16.8% lymphocytes), mild anemia (hemoglobin, 119 g/liter), and an accelerated erythrocyte sedimentation rate (45 mm/h). His total Tcell count and CD4 ϩ T-cell count were 0.317 ϫ 10 9 /liter and 0.012 ϫ 10 9 /liter, respectively. An abdominal computed tomography (CT) scan showed marked colonic dilatation and a possible narrowing at the rectosigmoid junction; pneumoperitoneum or ascites were absent (Fig. 1). An ensuing colonoscopy ruled out strictures and was remarkable only for a solitary sigmoidal ulcerative lesion (Fig. 2) which was subjected to a biopsy procedure (Fig. 3). Simultaneous control biopsy specimens taken from an endoscopically normal right colon revealed normal findings. An upper gastrointestinal endoscopy displayed no abnormalities. At that time, emergency, internal medicine, and surgery physicians were unable to ascertain the origin of the large bowel distension.Moreover, the patient's complaints required intravenous tramadol, paracetamol, and metamizole treatment. On the third hospital day, he developed a cutaneous, diffuse exanthematous papulovesicular rash most consistent with disseminated herpes zoster (Fig. 4)-one of these lesions was subjected to a biopsy procedure on the same day...

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Section: Case Reportmentioning

confidence: 90%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 1 more Smart Citation

Varicella-Zoster Virus (VZV) Infection as a Possible Cause of Ogilvie's Syndrome in an Immunocompromised Host

Carrascosa¹,

Salcines-Caviedes²,

Gómez-Román

et al. 2014

J Clin Microbiol

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show abstract

“…Notable exceptions include the following characteristics: atypical rashes, such as disseminated zoster or a minimal or absent dermatomal rash; zosteriform herpes simplex; modified (breakthrough) varicella in vaccinated individuals; and rashes caused by enteroviruses, poxviruses, rickettsia, drug reactions or contact dermatitis; and VZV infection in the absence of a rash. The latter includes, for example, zoster without rash (known as zoster sine herpete, sometimes with or without facial palsy 90 ), meningitis 1,91,92 , stroke 81,[93][94][95][96][97] , myelitis 98 and enteric (gastrointestinal) infections 45,[99][100][101][102] . In these settings, rapid diagnosis is necessary to plan appropriate therapy and public health measures.…”

Section: Diagnosis Screening and Prevention Diagnosismentioning

confidence: 99%

Varicella zoster virus infection

Suzuki

Suga²,

Asano³

2015

Nat Rev Dis Primers

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“…A literature review reported that rashes developed 1 day to several weeks after bowel symptom onset in 48%, 2 days to 1 month before bowel symptom onset in 28%, and simultaneously in 24%. 6 Zoster is not uncommon and is generally self-limited. However, it is a rare cause of ACPO, which has a high mortality rate if isch- …”

mentioning

confidence: 99%