RESUMO
Herpesvirus infections in solid organ transplant (SOT) recipients are a significant cause of morbidity and mortality. We report a case of herpes zoster (HZ) in a kidney transplant recipient while receiving belatacept, a CTLA-4 inhibitor that prevents acute rejection. The patient presented with oropharyngolaryngeal mucosal lesions that subsequently disseminated resulting in pneumonitis and meningo-encephalitis. Very late-onset HZ can occur and can present atypically in SOT recipients. Delayed recognition and treatment may result in poor outcomes, as illustrated by this case.
Assuntos
Herpes Zoster/diagnóstico , Herpesvirus Humano 3/isolamento & purificação , Transplante de Rim/efeitos adversos , Edema Laríngeo/virologia , Transtornos de Início Tardio/diagnóstico , Abatacepte/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Antivirais/uso terapêutico , Autopsia , Evolução Fatal , Feminino , Herpes Zoster/etiologia , Herpes Zoster/patologia , Herpes Zoster/virologia , Humanos , Imunossupressores/administração & dosagem , Edema Laríngeo/diagnóstico , Edema Laríngeo/patologia , Transtornos de Início Tardio/etiologia , Transtornos de Início Tardio/patologia , Transtornos de Início Tardio/virologia , Pessoa de Meia-Idade , Prednisona/uso terapêutico , TransplantadosRESUMO
Varicella zoster virus (VZV) infection of the head and neck region may present with various symptoms. I present two cases of VZV infection of the pharynx and larynx with multiple cranial nerve neuropathies. Their initial symptoms such as sore throat, odynophagia, and dysphasia were complicated by otalgia, dizziness, hearing loss, or ipsilateral facial nerve paralysis. All of these lesions tended to lateralize to the ipsilateral side and endoscopic findings suggested VZV infections, which were confirmed by serial serologic examinations.