Multidermatomal herpes zoster triggered by psychological stress in an immunocompetent young adult: a rare case report and clinical insights.

Introduction and Importance: Herpes zoster (HZ), a reactivated varicella zoster virus infection arising from dormant viral latency after initial chickenpox, manifests as localized skin rashes along dermatomes. Multidermatomal involvement, especially in immunocompetent individuals, is rare. The potential link between psychological stress and HZ reactivation remains underexplored. The authors present a case of multidermatomal HZ triggered by psychological stress in a young immunocompetent adult. Case presentation: A 26-year-old male presented with vesicular lesions spanning C5, C8, T1, and T2 dermatomes, triggered by psychological stress. The disease exhibited a unique midline-crossing presentation. The Varicella zoster virus IgM test result was positive. Treatment included acyclovir, pain management, and stress reduction strategies, yielding complete resolution within 3 weeks. Clinical discussions: The case highlights a distinctive multidermatomal HZ presentation, defying conventional dermatomal restrictions. Psychological stress potentially influenced viral reactivation. Immunocompetence and stress interplay merit further exploration. Multidermatomal HZ necessitates prompt clinical recognition and comprehensive evaluation. Antiviral therapy and integrated stress management may contribute to successful outcomes. Conclusion: This case underscores the rare occurrence of multidermatomal HZ in an immunocompetent young adult triggered by psychological stress. The atypical presentation and potential role of stress in viral reactivation emphasize the complex interaction between the nervous and immune systems. Integrated clinical management, stress reduction strategies, and antiviral therapy were effective in resolving the condition. Further research is warranted to elucidate the mechanisms underlying stress-induced viral reactivation and its clinical implications.

Varicella pneumonia in an immunocompetent child: A case report.

Varicella-zoster virus (VZV) is a type of herpes virus that causes varicella (primary infection) and herpes zoster/shingles (due to reactivation of latent infection). Usually a benign and a self-limited illness, the illness sometimes can result in severe complications in both immunocompetent and immunocompromised persons. Varicella Pneumonia as a complication of herpes zoster is a rare event, with reports primarily concerning immunocompromised individuals. Here we report a 14-year-old female who developed a secondary bacterial infection of the skin lesions and varicella pneumonia associated with VZV infection. The patient presented with multiple painful vesicles that later turned into pustular lesions over the right cheek with erosions and hemorrhagic crusting. Swelling involving the right half of both upper and lower lips was present. She developed a fever, cough, and shortness of breath after two days of the presence of vesico-pustular lesions. A diagnosis of Pneumonia was made based on symptoms of fever and cough and findings on chest x-ray. This case highlights, though rare, varicella pneumonia has a high rate of respiratory failure, but early diagnosis with prompt administration of antiviral medications can improve outcomes.

Wildlife in climate refugia: Mammalian diversity, occupancy, and tiger distribution in the Western Himalayas, Nepal.

Anthropogenic land-use change continues to be predicated as a major driver of terrestrial biodiversity loss for the rest of this century. It has been determined that the effect of climate change on wildlife population will accelerate the rate and process of decline of global vertebrate populations. We investigated wildlife composition, occupancy, and activity pattern along the larger climate resilient forests that serve as microrefugia for a wide range of species under the escalating climate change. We used camera trap survey covering 250 km2 of climate microrefugia in Dadeldhura hills in far western region of Nepal. We used 62 trapping locations accumulating 1800 trap nights taking 98,916 photographs in 62 days-survey period during the summer season of 2020. We photographed 23 mammalian species with estimated species richness of 30 species (95% CI: 25-34) based on multi-species occupancy model. We estimated overall species occupancy ψ(SE(ψ)) to be 0.87 (0.09) in climatic microrefugia. While human activity predominated throughout the day, the majority of animals was found to exhibit nocturnal temporal patterns. Tiger and hyaena, two of the top predators, were newly discovered in the western Himalayan range of Nepal, with their discovery at the 34 highest elevations of 2511 meters and 2000m, respectively. In Nepal, high-altitude tiger range is characterized by tiger distribution above a 2000 m cutoff representing habitats in the physiographic zone of high mountains and above. Our findings establish a baseline and show that the climatic microrefugia that have been identified have high levels of species richness and occupancy, which characterize the Dadeldhura hill forest ranges as biologically varied and ecologically significant habitat. These areas identified as climatic microrefugia habitats should be the focus of conservation efforts, particularly efforts to reduce human disturbance and adapt to climate change.