Herpes zoster. Case report of possible accidental inoculation

Abstract

A 30-year-old healthy male physician developed grouped, papulovesicular lesions along the dermatomes of T1 and T2 of the left side of his body. The onset occurred two days after he accidentally pricked his right index finger with a needle that had been used to aspirate the acute papulovesicular lesion of a patient with severe herpes zoster. The clinical appearance and dermatomal distribution, the subsequent clinical course, the skin biopsy findings, and the substantial increase in complement-fixing antibody titer to the varicella-zoster (V-Z) virus in the convalescent serum samples are strong evidence for herpes zoster. Although it is generally believed that person-to-person transmission of zoster is rare and that herpes zoster results from the reactivation of a latent varicella virus, the present case suggests that zoster can be acquired from exogenous infection with a V-Z virus, at least in certain circumstances.

Infection risks following accidental exposure to blood or body fluids in health care workers: A review of pathogens transmitted in published cases

“…23,24 One case of virus varicella-zoster inoculation may have led to zoster in a physician after he had sampled a vesicle in a patient. 25 Zoonotic viruses. Zoonotic viruses have also been transmitted across the interspecies barrier by exposure to BBF.…”

Viral infections in workers in hospital and research laboratory settings: a comparative review of infection modes and respective biosafety aspects

“…Of a total of 12 cases of accidental infection with viruses of preferential mucocutaneous mode of infection, only four took place in the hospital setting. Of these, one was a case of Lassa virus infection reported in 1970, one was caused by MARV, another was a herpes zoster virus (HZV) 67 infection with percutaneous mode of infection that developed clinically as zoster after 2 days of incubation, and one was a herpes simplex virus 1 (HSV-1; now named HHV-1, human herpes virus 1) percutaneous infection that developed as herpetic whitlow 4 days after a needlestick injury to the finger with a contaminated 22-gauge needle. 68 Table 5 shows that the percutaneous mode of infection has equal if not higher importance than the mucocutaneous mode, the conventional mode, an expected fact for both types of setting.…”

Needlecaps to Prevent Needlestick Injuries

“…Other maladies attributed to accidental needlesticks have included herpetic whitlow, 10 a drug-resistant tuberculosis infection," malaria, 1 -varicella zoster viral infection, 13 and Rocky Mountain Spotted Fever. 1 ' 1 One prospective study of sharp injuries of hospital employees in which there were no cases of hepatitis nonetheless reported one cellulitis, two local infections, one case of syphilis, and a Staphylococcus aureus bacteremia with endocarditis for which the employee sought and received compensation (DRG#126, PMH value $7,760), all during a 30-month period.…”