Management and Prevention of Generalized Herpes Zoster in Elderly Patients in the Convalescent Rehabilitation Ward：A Case Report / The Japanese Journal of Rehabilitation Medicine

ABSTRACT

A 95-year-old woman was admitted to our hospital for rehabilitation after a subarachnoid hemorrhage, but her physical function deteriorated due to repeated aspiration pneumonia. On the first day of the illness, a painless erythema appeared on the right elbow fossa, and expanded soon afterwards. She developed a fever of unknown origin, which led us to the diagnosis of generalized herpes zoster by using a rapid diagnostic kit. The patient was placed in a private room to prevent nosocomial infection, and we took contact infection prevention measures, such as, restricting the number of staff in the room. Antiviral drugs were administered to the patient, quickly relieving her fever. The erythema became encrusted in about 2 weeks, and private room management was terminated.Recently, due the start of periodic vaccination, the incidence of varicella has decreased；however, the increasing incidence of herpes zoster infections among the elderly remains a concern, since the onset of herpes zoster infections is inhibited by the booster effect of contact with varicella patients. Many patients are at a high risk for herpes zoster in convalescent rehabilitation wards due to the long-term admission of elderly patients with underlying diseases. Because more patients with severe herpes zoster are expected in convalescent rehabilitation wards in the future, we herein reexamine the management of such patients from the perspective of early diagnosis, nosocomial infection prevention measures, and prevention of herpes zoster onset.