Rectal Ulcer in a Patient with VZV Sacral Meningoradiculitis (Elsberg Syndrome)

Matsumoto, Hideyuki; Shimizu, Takahiro; Tokushige, Shin‐ichi; Mizuno, Hideo; Igeta, Yukifusa; Hashida, Hideji

doi:10.2169/internalmedicine.51.6514

Cited by 13 publications

(10 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the clinical manifestation of aseptic meningoencephalitis without a skin rash associated with Elsberg syndrome is common in patients with HSV-2 infection, the present case was due to VZV infection, which is an atypical clinical presentation. Another case report described Elsberg syndrome secondary to VZV infection with a skin rash complicated with rectal bleeding (13). In that report, the authors proposed several hypotheses for the rectal bleeding.…”

Section: Discussionmentioning

confidence: 97%

Varicella Zoster Virus Meningoencephalitis Presenting with Elsberg Syndrome without a Rash in an Immunocompetent Patient

et al. 2015

View full text Add to dashboard Cite

Varicella zoster virus (VZV) infection usually manifests with a skin rash. To the best of our knowledge, this is the first report of a case of VZV meningoencephalitis presenting with Elsberg syndrome without a rash in an immunocompetent patient. Clinicians should consider the potential for VZV infection as well as herpes simplex virus infection in cases of aseptic meningitis accompanied by bladder and rectal disturbances, even in patients without any rash symptoms.

show abstract

Section: Discussionmentioning

confidence: 97%

Varicella Zoster Virus Meningoencephalitis Presenting with Elsberg Syndrome without a Rash in an Immunocompetent Patient

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Urinary problems include neuropathic bladder [499], loss of voiding sensation [500] and occasional acute urinary retention [461, 501–503]. Other complications include faecal incontinence [504] rectal ulcer [505] and sciatica [506]. …”

Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

View full text Add to dashboard Cite

BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.

show abstract

“…Aside from VZV vasculopathy, VZV can reactivate and infect the meninges, brain parenchyma and nerve roots to produce a VZV meningoencephalitis (18, 19); and meningoradiculitis (20, 21). In addition, VZV can cause cerebellitis (22, 23).…”

Section: Vzv Meningoencephalitis Meningoradiculitis and Cerebellitismentioning

confidence: 99%

Neurological complications of varicella zoster virus reactivation

Nagel¹,

Gilden

2014

Current Opinion in Neurology

151

129

View full text Add to dashboard Cite

Purpose of the review Varicella zoster virus (VZV) reactivation results in zoster, which may be complicated by postherpetic neuralgia, myelitis, meningoencephalitis and VZV vasculopathy. This review highlights the clinical features, laboratory abnormalities, imaging changes and optimal treatment of each of those conditions. Because all of these neurological disorders produced by VZV reactivation can occur in the absence of rash, the virological tests proving that VZV caused disease are discussed. Recent findings After primary infection, VZV becomes latent in ganglionic neurons along the entire neuraxis. With a decline in VZV-specific cell-mediated immunity, VZV reactivates from ganglia and travels anterograde to the skin to cause zoster, which is often complicated by postherpetic neuralgia. VZV can also travel retrograde to produce meningoencephaltis, myelitis and stroke. When these complications occur without rash, VZV-induced disease can be diagnosed by detection of VZV DNA or anti-VZV antibody in CSF and treated with intravenous acyclovir. Summary Awareness of the expanding spectrum of neurological complications caused by VZV reactivation with and without rash will improve diagnosis and treatment.

show abstract

Rectal Ulcer in a Patient with VZV Sacral Meningoradiculitis (Elsberg Syndrome)

Cited by 13 publications

References 11 publications

Varicella Zoster Virus Meningoencephalitis Presenting with Elsberg Syndrome without a Rash in an Immunocompetent Patient

Varicella Zoster Virus Meningoencephalitis Presenting with Elsberg Syndrome without a Rash in an Immunocompetent Patient

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Neurological complications of varicella zoster virus reactivation

Contact Info

Product

Resources

About