A rare case of disseminated cutaneous zoster in an immunocompetent patient

Gupta, Sachin; Jain, Atul; Gardiner, Carolyn; Tyring, Stephen K.

doi:10.1186/1471-2296-6-50

Cited by 25 publications

(20 citation statements)

References 6 publications

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“…Malignancy, HIV infection, therapy with immunosuppressive medications and diabetes all increase risk 19. Though DCHZ has been reported in immunocompetent individuals, it is rare 20. Two recent reviews identified only 30 cases of DCHZ in immunocompetent patients, the majority of whom were 65 years of age or older 21 22…”

Section: Discussionmentioning

confidence: 99%

Disseminated herpes zoster causing acute respiratory distress syndrome in an immunocompetent patient

Rudinsky

Jordan

2017

BMJ Case Reports

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Disseminated cutaneous varicella herpes zoster with visceral involvement is rare and seen almost exclusively in immunocompromised patients. We describe an unusual case of fulminant herpes zoster (HZ) in a healthy, immunocompetent 37-year-old woman. She initially presented to an urgent care centre with a classic HZ rash localised to her neck, and upper respiratory symptoms and was treated with prednisone and cephalexin. Within 1 week, the rash became diffuse and her clinical status rapidly deteriorated with development of severe acute respiratory distress syndrome. Varicella zoster infection was confirmed via skin biopsy, bronchial viral PCR and serology for varicella antibodies. She was successfully treated with intravenous acyclovir and aggressive supportive care. Though physicians readily recognise typical zoster infection, this case reminds clinicians that HZ infection can be fulminant and potentially life-threatening in younger, immunocompetent individuals. Early recognition and antiviral therapy is important to reduce morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Disseminated herpes zoster causing acute respiratory distress syndrome in an immunocompetent patient

Rudinsky

Jordan

2017

BMJ Case Reports

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“…The incidence rate of disseminated herpes zoster infections is very high, at 10-40% in patients with decreased immunity, especially in patients with HIV infections, hematological malignancies, and those who are undergoing chemotherapy, since they have a decreased number and decreased activity of T lymphocytes. The recurrence rate is also high, so 10 mg/kg (or 500 mg/m 2 ) of acyclovir is IV administered every 8 hours and replaced with oral agents (valacyclovir, famciclovir) when symptoms are controlled, or patients with less severe immune suppression can be administered with oral agents from the beginning [2-6]. …”

Section: Discussionmentioning

confidence: 99%

Disseminated Herpes Zoster in an Immunocompetent Elderly Patient

et al. 2013

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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. Extensive cutaneous dissemination has been reported in immune-compromised patients, such as those who suffer from HIV infections, cancer, chemotherapy, and corticosteroid therapy patients. However, we report a case of disseminated herpes zoster infection in an immuno-competent elderly individual.

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“…Disseminated herpes zoster is defined as more than 20 small widespread vesicles resembling varicella outside the area of the primary and adjacent dermatomes, and may or may not involve visceral organs. It has been mainly described in the elderly or persons with immunosuppression due to HIV infection, hematologic malignancy, or chemotherapy; in otherwise healthy individuals it is very rarely reported 5,8,9 . Therefore, a patient with disseminated herpes zoster, with no known co-factors (as noted above) deserves a complete work-up to elucidate any underlying malignancy or immunodeficiency 3,4,10,11 .…”

Section: Discussionmentioning

confidence: 99%

A Case of Human Immunodeficiency Virus Infection Initially Presented with Disseminated Herpes Zoster

Shin

Song

et al. 2010

Ann Dermatol

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Herpes zoster is characterized by unilateral grouped vesicles along the distribution of a single dermatome. Disseminated herpes zoster usually is defined as a generalized eruption of more than 20 extra-dermatomal vesicles occurring within a week of the onset of classic dermatomal herpes zoster. It occurs chiefly in old or debilitated individuals, and especially in patients with underlying malignancy, immunosuppressive therapy, or human immunodeficiency virus (HIV) infection. A 51-year-old man presented with segmental grouped vesicles on the left upper trunk and arm, and a varicella-like eruption over the entire body. Tzanck smear preparation and punch biopsy done on the vesicles of the trunk indicated a herpetic infection. Later, he was found to be HIV-positive. We report a rare case of HIV infection initially presenting with disseminated herpes zoster.

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A rare case of disseminated cutaneous zoster in an immunocompetent patient

Abstract: Background: Disseminated cutaneous herpes zoster in healthy persons is uncommon, though it has been described in immunocompromised patients.

Cited by 25 publications

References 6 publications

Disseminated herpes zoster causing acute respiratory distress syndrome in an immunocompetent patient

Disseminated herpes zoster causing acute respiratory distress syndrome in an immunocompetent patient

Disseminated Herpes Zoster in an Immunocompetent Elderly Patient

A Case of Human Immunodeficiency Virus Infection Initially Presented with Disseminated Herpes Zoster

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