Herpes zoster is a distinct clinical syndrome that may present with a segmental zoster paresis. Although thoracic dermatomes are the most commonly affected, paresis of the abdominal muscles has been less frequently reported. To review the existing published evidence regarding this unusual clinical entity, a literature search of PubMed and Google was performed. In total, 35 articles that described 36 individual cases were identified. The information from all the cases was tabulated for the analysis. The mean age was 67.5 years. The ratio of men to women was approximately 4:1. The left and right side were approximately equally affected. The most affected associated dermatome was T11. In 88.9% of the patients, the typical herpetic rash preceded the abdominal weakness. The mean latent period from rash to onset of abdominal muscle weakness was 3.5 weeks. Electrodiagnostic studies confirmed the diagnosis in 95% of the tested patients. Complete recovery with conservative measures occurred in 79.3% of the patients who were followed-up for recovery, with a mean time for recovery of 4.9 months. Visceral neuropathy co-occurred in 19.4% of the patients. Because of its self-limited nature and good prognosis, recognition of this complication is important to prevent unnecessary diagnostic studies and procedures. Electrodiagnostic studies can be effectively used to confirm the diagnosis. Because visceral neuropathy commonly co-occurs with segmental zoster abdominal paresis, it should be actively investigated and treated.

IntroductionPhantom limb sensation and phantom limb pain is a very common issue after amputations. In recent years there has been accumulating data implicating 'mirror visual feedback' or 'mirror therapy' as helpful in the treatment of phantom limb sensation and phantom limb pain.Case presentationWe present the case of a 24-year-old Caucasian man, a left upper limb amputee, treated with mirror visual feedback combined with auditory feedback with improved pain relief.ConclusionThis case may suggest that auditory feedback might enhance the effectiveness of mirror visual feedback and serve as a valuable addition to the complex multi-sensory processing of body perception in patients who are amputees.

Herpes zoster is a clinical syndrome which usually presents with a localized, vesicular rash in a dermatomal distribution. Cutaneous dissemination rarely occurs in immunocompetent patients, therefore little is known about the baseline demographic, clinical characteristics, management and outcome of these patients. Herein, we report a case of disseminated cutaneous herpes zoster in an immunocompetent patient along with a review and analysis of 28 cases previously reported in the literature.

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Shewanella putrefaciens rarely causes infection in humans. In the last few decades a growing number of cases have been described. The following report outlines the case of a 40-year-old immunocompetent white man with S. putrefaciens infective endocarditis. This is the first known case of infective endocarditis due to an apparently monomicrobial S. putrefaciens infection, and the second known case of S. putrefaciens-related infective endocarditis worldwide.

Giant inguinoscrotal hernias are uncommon nowadays, however, they may still occasionally present after years of neglect[1]. Significant morbidity and decreased quality of life may be associated with them. They may cause urinary retention, skin ulcers and infection, and decreased mobility apart from the classical complications of inguinoscrotal hernias[2]. A 71-year-old man with multiple medical problems, including chronic cardiac and pulmonary disease, was admitted to our inpatient rehabilitation unit after acute hospitalization due to pneumonia. During the routine physical examination, a huge inguinoscrotal hernia extending to the knee level was observed (see figure). The patient reported that he noticed the hernia 7 years ago and it has been increasing in size since then. His mobility was decreased due to the size of the hernia as well as general deconditioning. After discussion with the patient, the decision was made not to proceed with surgical treatment due to the significantly increased operative risk. Although surgical treatment seems to be the only reasonable treatment for giant inguinoscrotal hernias, forced reduction of hernial contents back into the contracted peritoneal cavity may alter the intra

We read with interest an article by Yoon et al. published in The Korean Journal of Pain [1]. This article describes a case of disseminated herpes zoster in immunocompetent elderly patient with previous medical history of diabetes mellitus. Although disseminated herpes zoster is common in the immunocompromised patient, it is a rare clinical finding in the immunocompetent patient. The reactivation of varicella-zoster virus (VZV) occurs with the decline of VZV-specific cell-mediated immunity. Studies have shown increased incidence of herpes zoster incidence in diabetic patients [2,3]. Furthermore, Okamoto et al. compared VZV-specific immunity of patients with diabetes mellitus and healthy individuals and found that patients with diabetes mellitus had significantly lower cell-mediated immunity to VZV than did healthy individuals [4]. They suggested that the increased risk for herpes zoster among patients with diabetes mellitus may be related to decreased VZV-specific cell-mediated immunity. Although more evidence is needed to find the exact mechanism by which diabetes mellitus affects VZV-specific cell-mediated immunity, physicians should be aware that diabetes mellitus may be a condition compromising the immune competency of the patient against VZV infection.

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