Herpes Zoster: a case series with different manifestations

Hasnikmah Mappamasing; Diah Mira Indramaya; Trisniartami Setyanigrum; Rahmadewi

doi:10.15562/bmj.v12i1.3834

Herpes Zoster: a case series with different manifestations

Hasnikmah Mappamasing ,

Diah Mira Indramaya ,

Trisniartami Setyanigrum ,

Rahmadewi ,

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DOI: https://doi.org/10.15562/bmj.v12i1.3834 |
Published: 2023-02-23

Abstract

Background: The incidence of herpes zoster appears to correlate inversely with the host's ability to mount a cellular immune response. The disease is characterized clinically by an acute rash with herpetiform blisters on the skin and mucous membranes. This case series presented the different clinical presentations of herpes zoster infection in three patients with different underlying diseases in the ophthalmic, trigeminal, cervical, and thoracic dermatomes.

Case Presentation: Three cases of herpes zoster were observed in this case series. The first case involved the ophthalmic division of the trigeminal nerve. The second case involved the cervical nerve, and the last case involved the thoracic nerve. All had undergone varicella infection in childhood and suffered from various states leading to immunosuppression. Tzanck smears were performed in all cases, which showed multinucleated giant cells. After treatment following the herpes zoster protocol, all cases healed without complications.

Conclusion: Reactivation of the varicella-zoster virus may occur spontaneously or when host immunity is weakened. Increasing age, a physical trauma (including dental procedures), psychological stress, malignancy, and immunocompromised conditions, including transplant recipients, pregnancy, and HIV infection, are predisposing factors for varicella-zoster virus reactivation.

References

Marra F, Parhar K, Huang B, Vadlamudi N. Risk Factors for Herpes Zoster Infection: A Meta-Analysis. Open Forum Infect Dis. 2020;7(1):ofaa005.
Patil A, Goldust M, Wollina U. Herpes zoster: A Review of Clinical Manifestations and Management. Viruses. 2022;214(2):192.
Muchtar E, Koehler AB, Johnson MJ, Rabe KG, Ding W, Call TG, et al. Humoral and cellular immune responses to recombinant herpes zoster vaccine in patients with chronic lymphocytic leukemia and monoclonal B cell lymphocytosis. Am J Hematol. 2022;97(1):90–98.
Freer G, Pistello M. Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. New Microbiol. 2018;41(2):95-105.
Schmader K. Herpes Zoster. Ann Intern Med. 2018;169(3):ITC19-ITC31.
Raj SS, Verma P, Mahajan P, Puri A. Herpes zoster infection of the face: A case report with review of literature. J Indian Acad Oral Med Radiol. 2017;29(2):159-161.
Soni A. Herpes zoster: A case series with varied clinical presentations. Indian J Case Rep. 2018;4(4):253–257.
Kraiem S, Abdallah MB, Moussa K, Laajili H. Herpes zoster during pregnancy about one case report. PAMJ - Clin Med. 2020;2(144):1-4.
Schafer R, Davis M, Phillippi JC. Herpes zoster in pregnancy. J Midwifery Womens Health. 2019;64(2):230–235.
Davis AR, Sheppard J. Herpes Zoster Ophthalmicus Review and Prevention. Eye Contact Lens. 2019;45(5):286-291.
Wollina U. Variations in herpes zoster manifestation, Indian J Med Res. 2017;145(3):294–298.
Miller SC, Cox JM, Olding KJ. Cervical Radiculopathy Associated With Shingles Herpes Zoster Infection. J Chiropr Med. 2019;18(3):225–228.
Hayward K, Cline A, Stephens A, Street L. Management of herpes zoster (shingles) during pregnancy. J Obstet Gynaecol. 2018;38(7):887–894.
Pupco A, Bozzo P, Koren G. Herpes zoster during pregnancy. Can Fam Physician. 2011;57(10):1133.
Purwoko MIH, Darmawan H. Herpes Zoster: Clinical Manifestation, Treatment, and Prevention. Biosci Med J Biomed Transl Res. 2020;4(3):34–44.
Sauerbrei A, Eichhorn U, Schacke M, Wutzler P. Laboratory diagnosis of herpes zoster. J Clin Virol. 1999;14(1):31–36.
Panwar H, Joshi D, Goel G, Asati D, Majumdar K, Kapoor N. Diagnostic Utility and Pitfalls of Tzanck Smear Cytology in Diagnosis of Various Cutaneous Lesions. J Cytol. 2017;34(4):179–182.
Yaeen A, Ahmad QM, Farhana A, Shah P, Hassan I. Diagnostic value of Tzanck smear in various erosive, vesicular, and bullous skin lesions. Indian Dermatol Online J. 2015;6(6):381–386.
Bhargah A, Jayantika IGABK, Prabawa IPY, Manuaba IBP. Spontaneous conversion to sinus rhythm in atrial fibrillation after dual antiplatelet and anticoagulant therapy in patients with unstable angina. Bali Medical Journal. 2020;9(3):664–667.
Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, et al. Recommendations for the management of herpes zoster, Clin Infect Dis. 2007;44(1):S1–26.
Adiguna MS, Wijaya H, Saientisna MD. Herpes zoster opthalmicus in geriatric with malnutrition: a case report. Bali Medical Journal. 2020;9(1):303–307.

[1] Marra F, Parhar K, Huang B, Vadlamudi N. Risk Factors for Herpes Zoster Infection: A Meta-Analysis. Open Forum Infect Dis. 2020;7(1):ofaa005.

[2] Patil A, Goldust M, Wollina U. Herpes zoster: A Review of Clinical Manifestations and Management. Viruses. 2022;214(2):192.

[3] Muchtar E, Koehler AB, Johnson MJ, Rabe KG, Ding W, Call TG, et al. Humoral and cellular immune responses to recombinant herpes zoster vaccine in patients with chronic lymphocytic leukemia and monoclonal B cell lymphocytosis. Am J Hematol. 2022;97(1):90–98.

[4] Freer G, Pistello M. Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. New Microbiol. 2018;41(2):95-105.

[5] Schmader K. Herpes Zoster. Ann Intern Med. 2018;169(3):ITC19-ITC31.

[6] Raj SS, Verma P, Mahajan P, Puri A. Herpes zoster infection of the face: A case report with review of literature. J Indian Acad Oral Med Radiol. 2017;29(2):159-161.

[7] Soni A. Herpes zoster: A case series with varied clinical presentations. Indian J Case Rep. 2018;4(4):253–257.

[8] Kraiem S, Abdallah MB, Moussa K, Laajili H. Herpes zoster during pregnancy about one case report. PAMJ - Clin Med. 2020;2(144):1-4.

[9] Schafer R, Davis M, Phillippi JC. Herpes zoster in pregnancy. J Midwifery Womens Health. 2019;64(2):230–235.

[10] Davis AR, Sheppard J. Herpes Zoster Ophthalmicus Review and Prevention. Eye Contact Lens. 2019;45(5):286-291.

[11] Wollina U. Variations in herpes zoster manifestation, Indian J Med Res. 2017;145(3):294–298.

[12] Miller SC, Cox JM, Olding KJ. Cervical Radiculopathy Associated With Shingles Herpes Zoster Infection. J Chiropr Med. 2019;18(3):225–228.

[13] Hayward K, Cline A, Stephens A, Street L. Management of herpes zoster (shingles) during pregnancy. J Obstet Gynaecol. 2018;38(7):887–894.

[14] Pupco A, Bozzo P, Koren G. Herpes zoster during pregnancy. Can Fam Physician. 2011;57(10):1133.

[15] Purwoko MIH, Darmawan H. Herpes Zoster: Clinical Manifestation, Treatment, and Prevention. Biosci Med J Biomed Transl Res. 2020;4(3):34–44.

[16] Sauerbrei A, Eichhorn U, Schacke M, Wutzler P. Laboratory diagnosis of herpes zoster. J Clin Virol. 1999;14(1):31–36.

[17] Panwar H, Joshi D, Goel G, Asati D, Majumdar K, Kapoor N. Diagnostic Utility and Pitfalls of Tzanck Smear Cytology in Diagnosis of Various Cutaneous Lesions. J Cytol. 2017;34(4):179–182.

[18] Yaeen A, Ahmad QM, Farhana A, Shah P, Hassan I. Diagnostic value of Tzanck smear in various erosive, vesicular, and bullous skin lesions. Indian Dermatol Online J. 2015;6(6):381–386.

[19] Bhargah A, Jayantika IGABK, Prabawa IPY, Manuaba IBP. Spontaneous conversion to sinus rhythm in atrial fibrillation after dual antiplatelet and anticoagulant therapy in patients with unstable angina. Bali Medical Journal. 2020;9(3):664–667.

[20] Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, et al. Recommendations for the management of herpes zoster, Clin Infect Dis. 2007;44(1):S1–26.

[21] Adiguna MS, Wijaya H, Saientisna MD. Herpes zoster opthalmicus in geriatric with malnutrition: a case report. Bali Medical Journal. 2020;9(1):303–307.

Herpes Zoster: a case series with different manifestations

Abstract

References

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