RESUMO
OBJECTIVES: The aim of this study was to define the typical pattern for varicella zoster virus (VZV) reactivation in delayed facial palsy (DFP) after stapedectomy for otosclerosis. MATERIALS AND METHODS: Review of the relevant literature, personal casistics, and case-report. RESULTS: In total, 48 cases of DFP after stapes surgery have been described so far, including the reported case with exclusive manifestation of atypical Ramsay Hunt syndrome (RH); in the personal series of 1253 stapedectomies, DFP occurred in only one case (0.08%). Complete DFP (House-Brackmann grade VI) rapidly developed 12 days after surgery; RH appeared 2 days later, confirming the role of VZV. The DFP started improving after 8 weeks and completely recovered 6 months later. CONCLUSION: Acute otalgia prior to DFP should raise the suspicion of VZV reactivation. Atypical RH is the most frequent pattern that occurs in DFP after stapedectomy.
Assuntos
Paralisia Facial/etiologia , Herpes Zoster da Orelha Externa/etiologia , Otosclerose/cirurgia , Cirurgia do Estribo/efeitos adversos , Zoster Sine Herpete/diagnóstico , Aciclovir/administração & dosagem , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Nervo Facial/patologia , Nervo Facial/virologia , Paralisia Facial/diagnóstico , Paralisia Facial/fisiopatologia , Paralisia Facial/virologia , Feminino , Herpes Zoster da Orelha Externa/classificação , Herpes Zoster da Orelha Externa/diagnóstico , Herpes Zoster da Orelha Externa/tratamento farmacológico , Herpesvirus Humano 3/isolamento & purificação , Herpesvirus Humano 3/patogenicidade , Humanos , Incidência , Pessoa de Meia-Idade , Otosclerose/classificação , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/virologia , Estudos Retrospectivos , Cirurgia do Estribo/métodos , Fatores de Tempo , Resultado do Tratamento , Ativação Viral , Zoster Sine Herpete/complicações , Zoster Sine Herpete/tratamento farmacológicoRESUMO
This review on herpes simplex virus type I and type II (HSVI, HSVII) summarizes recent developments in clinical manifestations and treatment interventions for primary and recurrent orolabial and genital herpes, as well as those regarding vaccination issues. Among the clinical presentations, the relationship between pyogenic granuloma and chronic HSVI infection; HSV-related folliculitis; verrucous HSVI and HSVII lesions; the role of recurrent HSVI infection in burning mouth syndrome; HSVI and HSVII infection of the periareolar area; zosteriform HSV; the "knife-cut sign"; and the preferential colonization and infection of preexisting dermatoses by HSVI or HSVII are discussed. The usual antiviral treatment regimens for primary and recurrent orolabial and genital herpes are compared to short-term and one-day treatment options. New anti-HSVI and anti-HSVII agents include amenavir, pritelivir, brincidofovir, valomaciclovir, and FV-100. Therapeutic or preventive vaccination against HSVI and HSVII infections still remains a highly desirable treatment aim, which, unfortunately, has no clinically relevant applications to date.
Assuntos
Herpes Simples/virologia , Herpesvirus Humano 1/patogenicidade , Herpesvirus Humano 2/patogenicidade , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Síndrome da Ardência Bucal/diagnóstico , Síndrome da Ardência Bucal/tratamento farmacológico , Síndrome da Ardência Bucal/virologia , Herpes Genital/diagnóstico , Herpes Genital/tratamento farmacológico , Herpes Genital/virologia , Herpes Labial/diagnóstico , Herpes Labial/tratamento farmacológico , Herpes Labial/virologia , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Recidiva , Estomatite Herpética/diagnóstico , Estomatite Herpética/tratamento farmacológico , Estomatite Herpética/virologia , Vacinação , Virulência , Zoster Sine Herpete/diagnóstico , Zoster Sine Herpete/tratamento farmacológico , Zoster Sine Herpete/virologiaRESUMO
Varicella-zoster virus reactivation causes zoster (shingles), a syndrome characterized by severe pain and a vesicular rash. The present report details a case of varicella-zoster virus reactivation of the maxillary and mandibular division of the right trigeminal nerve without evidence of vesicular rash (zoster sine herpete). It is difficult to identify owing to no typical clinical signs such as vesicular eruption. Zoster sine herpete of the trigeminal nerve, in particular, is rarely reported. In this case, the diagnosis was based on clinical findings and was supported by the demonstration of an immunoglobulin G antibody. Zoster sine herpete of the trigeminal nerve, in particular, should be considered in patients with severe facial pain over specific dermatomes, if they do not demonstrate appreciable findings of traumatic neuropathy, tumor or herpes zoster.