A Fatal Case of Atypical Disseminated Herpes Zoster in a Patient with Meningoencephalitis and Seizures Associated with Steroid Immunosuppression.

BACKGROUND Herpes zoster is caused by the reactivation of the varicella zoster virus (VZV) and usually presents with vesicular skin lesions with a dermatomal distribution. Disseminated herpes zoster (DHZ) infection is characterized by non-dermatomal skin eruptions, often with involvement of other organs, and occurs in immunocompromised patients. CASE REPORT A 69-year-old man who was treated with prednisolone for amiodarone-associated interstitial lung disease, presented with seizures and altered consciousness. He had an erythematous rash with raised vesicles involving the skin of the genital region, left thigh, and abdomen. Following a diagnosis of DHZ with herpes zoster meningoencephalitis, he was treated with intravenous acyclovir. However, his level of consciousness did not improve, and he died of respiratory failure due to aspiration pneumonia. CONCLUSIONS A diagnosis of DHZ should be considered in immunosuppressed patients treated with steroids who present with seizures. A detailed search for skin eruptions should be conducted to enable early diagnosis and treatment.

Simultaneous multi-element analysis of total As, Se and Sb on titanium dioxide by slurry sampling-graphite furnace atomic absorption spectrometry.

A simple and rapid method for simultaneous determination of As, Se and Sb was studied by graphite furnace atomic absorption spectrometry (GFAAS). Titanium dioxide adsorbing As, Se and Sb was separated from sample solution (100ml) with a membrane filtration (0.45mum), and then prepared to be slurry (5.0ml) by adding ultrapure water. The behavior and influence of titanium dioxide on determination of As, Se and Sb were investigated in this experiment. The optimal conditions of a furnace for these elements were chosen as follows: pyrolysis temperature was 150 degrees C, and atomization temperature was 2300 degrees C. The optimal conditions of adsorption for As, Se and Sb on titanium dioxide were listed: pH 2.0 in sample solution; 10min of stirring time; and 20.0mg titanium dioxide. The difference of the chemical valence of each element had no effect on the recovery of each element at the same optimal conditions. Limits of detection (3sigma) for As, Se and Sb were found to be 0.21mugl(-1), 0.15mugl(-1) and 0.15mugl(-1), respectively, with enrichment rate of 20, when 20mul of slurry was injected into a Zr-coating tube. The proposed method was applied to tap water and river water.