Orbital apex syndrome due to herpes zoster infection in a patient with chronic kidney disease: A case report

Abstract

We report the case of an 89‐year‐old man with typical herpes zoster ophthalmicus on the left side of his face with delayed clinical presentation of orbital apex syndrome. After treatment with intravenous antiviral agents and corticosteroids, the patient fully recovered. Clinical suspicion should be concerned in immunocompromised cases.

A Rare and Complex Diagnostic Challenge: Herpes Zoster Ophthalmicus With Secondary Orbital Apex Syndrome in a 65-Year-Old Male

“…Similarly, in our case, orbital MRI with contrast and MRV demonstrated orbital myositis with mid-enhancement of the optic nerve perineural sheath, without any evidence of cavernous sinus thrombosis. This is an important finding, as venous sinus thrombosis can occur as a complication of OAS secondary to herpes zoster ophthalmicus and is associated with a poor prognosis [ 7 ].…”

A Rare and Complex Diagnostic Challenge: Herpes Zoster Ophthalmicus With Secondary Orbital Apex Syndrome in a 65-Year-Old Male

“…Similarly, in our case, orbital MRI with contrast and MRV demonstrated orbital myositis with mid-enhancement of the optic nerve perineural sheath, without any evidence of cavernous sinus thrombosis. This is an important finding, as venous sinus thrombosis can occur as a complication of OAS secondary to herpes zoster ophthalmicus and is associated with a poor prognosis [ 7 ].…”

A Rare and Complex Diagnostic Challenge: Herpes Zoster Ophthalmicus With Secondary Orbital Apex Syndrome in a 65-Year-Old Male

“…Similarly, in our case, orbital MRI with contrast and MRV demonstrated orbital myositis with mid-enhancement of the optic nerve perineural sheath, without any evidence of cavernous sinus thrombosis. This is an important finding, as venous sinus thrombosis can occur as a complication of OAS secondary to herpes zoster ophthalmicus and is associated with a poor prognosis [ 7 ].…”

A Rare and Complex Diagnostic Challenge: Herpes Zoster Ophthalmicus With Secondary Orbital Apex Syndrome in a 65-Year-Old Male

“…Similarly, in our case, orbital MRI with contrast and MRV demonstrated orbital myositis with mid-enhancement of the optic nerve perineural sheath, without any evidence of cavernous sinus thrombosis. This is an important finding, as venous sinus thrombosis can occur as a complication of OAS secondary to herpes zoster ophthalmicus and is associated with a poor prognosis [ 7 ].…”