Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.068
Filtrar
1.
BMC Health Serv Res ; 21(1): 1221, 2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34763679

RESUMO

BACKGROUND: Immunopreventable diseases are a public health reality in Brazil and worldwide, a reality that is not exclusive to children, but affects the adult population. OBJECTIVES: Discriminating the total costs of hospitalizations from immunopreventable diseases in the population aged 20 to 59 years. METHODS: A population, observational, descriptive, retrospective study was conducted with secondary information from DATASUS to discriminate the hospitalizations associated with immunopreventable diseases in Brazil and their care costs, within the Scope of the SUS, between 2008 and 2018, in the economically active population (20 to 59 years). RESULTS: It was analyzed 127,746 hospitalizations for immunopreventable diseases, (27.92% of all hospitalizations) were observed in the adult population, totaled R$115,682,097.54 (29.72% of the total costs). Of this population studied, 51.48% were registered as male; 66.74% were associated with influenza disease; 16.05% to chickenpox/herpes zoster infection and 7.55% to acute hepatitis B infections. The trend analysis of the time series of hospitalizations in this population showed a stationary trend. CONCLUSIONS: The 127,746 hospitalizations could be avoided with immunization, and 127,746 workers who could be working and not hospitalized. There were also R$115,682,097.54 that could be invested in other public health needs, which became necessary for the treatment of preventable diseases.


Assuntos
Herpes Zoster , Custos Hospitalares , Adulto , Brasil/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(11): 1328-1331, 2021 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-34749477

RESUMO

Based on Yichang health big data platform, 850 608 patients from September 2018 to September 2019 were included in this study. According to the date of birth, the participants were divided into early childhood famine exposure group, fetal famine exposure group and non-famine exposure group. The incidence of adult herpes zoster (HZ) in Yichang city was analyzed, and the correlation between early life famine exposure and adult HZ was analyzed. In 2019, the crude incidence rate of adult HZ in Yichang was 6.83‰. The crude incidence rate of adult HZ in females (7.26‰) was higher than that in males (6.40‰). Compared with the non-famine exposure group, fetal famine exposure was associated with the incidence of adult HZ (OR=1.21; 95%CI: 1.01-1.45, P=0.041). After stratification by sex, fetal famine exposure was only found to be associated with the onset of adult HZ in females (OR=1.28, 95%CI:1.02-1.61, P=0.034).


Assuntos
Herpes Zoster , Efeitos Tardios da Exposição Pré-Natal , Adulto , Pré-Escolar , Fome Epidêmica , Feminino , Herpes Zoster/epidemiologia , Humanos , Incidência , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
3.
Rev Med Liege ; 76(11): 773-775, 2021 Nov.
Artigo em Francês | MEDLINE | ID: mdl-34738748

RESUMO

Postherpetic neuralgia is the most feared complication of herpes zoster (HZ). The incidence increases with age. Nevertheless, around 5 % of HZ patients will experience a motor deficiency known as segmental zoster paresis (SZP) according to the affected dermatome. Abdominal pseudohernia is an exceptional clinical presentation of SZP, involving the T6-L1 dermatomas. The recognition of this rare complication of HZ prevents unnecessary explorations and interventions. There is no specific treatment but in general the evolution is favorable and spontaneous healing is observed within several months.


Assuntos
Parede Abdominal , Herpes Zoster , Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Humanos , Paresia
4.
Am J Case Rep ; 22: e934658, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34788266

RESUMO

BACKGROUND Ramsay Hunt syndrome is a rare form of herpes zoster caused by the reactivation of the varicella-zoster virus in the geniculate ganglion. The main clinical manifestations are peripheral facial palsy, vesicular rash in the ear, and ipsilateral auricular pain, and sometimes vertigo. COVID-19 is a new multisystemic infectious disease that, in addition to common respiratory manifestations, it is known to affect the immune system, primarily depressing cellular immunity. CASE REPORT A 54-year-old woman was admitted to our hospital with an acute vestibular syndrome and diplopia. She had been diagnosed 3 years prior with interstitial lung disease for which she was taking methylprednisolone. At admission, she tested positive for SARS-CoV-2. In the following days, she developed a sixth nerve palsy on the left side and a right peripheral facial palsy on the right side, followed by a typical zoster rash on the ipsilateral ear. One month later, she developed acute severe hearing loss on the right side. There were no COVID-19 symptoms during her stay in our hospital. The MRI showed Gd enhancement of both facial nerves. Under antiviral and corticoid treatment, the evolution was favorable, with marked improvement at 6 months. CONCLUSIONS COVID-19 increases the risk for herpes zoster infection, probably through induced depression of the cellular immunity. Our case suggests Ramsay Hunt syndrome can be the presenting symptom and sometimes the only symptom of COVID-19. This also seems to be true for other cranial neuropathies, and we recommend testing these patients even if there are no other manifestations.


Assuntos
COVID-19 , Herpes Zoster da Orelha Externa , Herpes Zoster , Polineuropatias , Feminino , Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Herpes Zoster da Orelha Externa/diagnóstico , Herpes Zoster da Orelha Externa/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , SARS-CoV-2
5.
Ann Palliat Med ; 10(10): 11221-11225, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763480

RESUMO

Postherpetic neuralgia (PHN) is a common and severe chronic complication of the herpes zoster (HZ) virus (shingles) involving prolonged pain which may last from weeks to years. Primary treatment involves oral therapies, although few patients experience a pain reduction of greater than 50%. Due to limited effective treatments, symptoms and comorbidities, including physical disability and emotional distress, are recurrent, and interfere with daily activities and sleep. A 34-year-old male had experienced refractory PHN on the right 3 to 5 thoracic dermatomes for about 3.5 years, accompanied with mood and sleep disorder. During this time, several treatments had been attempted, including systemic tricyclic antidepressants, opioid analgesics, anticonvulsants, topical lidocaine, epidural block, and spinal cord stimulation (SCS); however, their outcomes had been unsatisfactory. Low frequency sound stimulation (LFSS) was found effective in reducing the pain, and improving the state of both mood and the sleep. At the time of this report, the patient had been using this treatment for more than 240 days, his quality of life had improved significantly, and no side effects had been observed. LFSS is component of musical therapy, which categorized under complementary and alternative medicine (CAM). It uses audible sound (40-120 Hz) to produce a physical effect through the transducer when applied directly to the body, which can affect pain perception via mood and sleep improvement, activating an anti-pain effect in the brain. This case provides a rationale to study LFSS in patients with refractory neuropathic pain.


Assuntos
Herpes Zoster , Neuralgia Pós-Herpética , Transtornos do Sono-Vigília , Adulto , Analgésicos/uso terapêutico , Herpes Zoster/tratamento farmacológico , Humanos , Masculino , Neuralgia Pós-Herpética/tratamento farmacológico , Qualidade de Vida , Transtornos do Sono-Vigília/tratamento farmacológico
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(9): 1650-1661, 2021 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814597

RESUMO

Objective: To systematically analyze and evaluate the IgG antibody levels of varicella-zoster virus (VZV) in healthy population in China. Methods: CNKI, Wanfang, CBM and PubMed databases were used for the retrieval of literatures about VZV IgG antibody levels in healthy people in China from January 1, 2000 to November 3, 2020. The quality of the included papers was evaluated by the critical appraisal tools for cross sectional study from Joanna Briggs Institute (JBL). The stratified analysis on the IgG antibody levels in populations in different age groups, provinces, regions, gender groups, and years was performed by using software Stata 14.0. Results: A total of 59 papers were included that met the inclusion criteria, including 51 papers in Chinese and 8 papers in English. There were 22 papers with quality score of 8, 16 papers with quality score of 7, 15 papers with quality score of 6, and 6 papers with quality score of 5. Meta-analysis showed that the positive rate of VZV IgG antibody in healthy population in China was 64% (95%CI:60%-67%, I2 =98.7%), and the IgG antibody levels were reported in the papers for 22 provinces of China. The positive rate of VZV IgG antibody was highest in Yunnan (79%, 95%CI: 64%-93%, I2 =94.7%) and lowest in Inner Mongolia (50%, 95%CI: 46%-54%); the positive rate of VZV IgG antibody was highest in Northeastern China (71%, 95%CI: 69%-73%) and lowest in Eastern China (62%, 95%CI: 57%-67%); the positive rate of VZV IgG antibody in urban population was higher than that in rural population (RR=1.08, 95%CI: 1.04-1.11). The positive rate of VZV IgG antibody in women was higher than that in men (RR=1.10, 95%CI: 1.08-1.11); the positive rate of VZV IgG antibody in the population increased with age; and the positive rate of VZV IgG antibody increased with the change of sampling time. Conclusion: The positive rate of VZV IgG antibody in healthy population in China was relatively low; the coverage of varicella vaccine should be improved for the outbreak control and incidence reduction of varicella in China.


Assuntos
Varicela , Herpes Zoster , Anticorpos Antivirais , Varicela/epidemiologia , Vacina contra Varicela , China/epidemiologia , Estudos Transversais , Feminino , Herpesvirus Humano 3 , Humanos , Masculino
7.
Reumatismo ; 73(3)2021 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-34814659

RESUMO

Since the severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) pandemic outbreak, vaccines gained a growing role. Possible vaccine-related side effects range from minor local events to more prominent systemic manifestations up to anaphylactic reactions. A heterogeneous spectrum of cutaneous reactions has been reported, ranging from local injection site reactions to urticarial and morbilliform eruptions, pernio/chilblains and zoster flares. Here, we describe a case of varicella zoster virus reactivation following mRNA coronavirus 2019 vaccine and discuss the available literature upon the topic published so far.


Assuntos
COVID-19 , Herpes Zoster , Espondilite Anquilosante , Vacinas contra COVID-19 , Humanos , RNA Mensageiro , SARS-CoV-2
8.
J Cosmet Dermatol ; 20(11): 3350-3361, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34719084

RESUMO

INTRODUCTION: Although the COVID-19 vaccination is deemed safe, exact incidence and nature if adverse effects, particularly dermatological ones, are still unknown. OBJECTIVE: To describe the demographic, clinical, morphological characteristics, outcomes, and timing of development of herpes zoster to the various COVID-19 vaccines. And to identify on whether COVID-19 vaccine has temporal relationship between development of herpes zoster (HZ). METHODS: We have performed a systemic review of articles from PubMed and Embase using MeSH and keywords like "Shingles," "Herpes zoster," "Varicella zoster," "COVID-19," "Vaccine," "SARS-CoV-2." No filters including country of publication, language, type of articles were applied. Individual case report references were filtered for any pertinent cases. RESULTS: A total of 54 cases consisting of 27 male and 27 female patients have been reported. There were cases with known risk factors for herpes zoster, which included age more than 50 years (n = 36), immunological disorders (n = 10), chronic disease (n = 25), metabolic disorder (n = 13), malignancy (n = 4), and psychiatric disorder (n = 2). The mean (SD) period between development of herpes zoster and COVID-19 vaccination was 7.64 (6.92) days. Majority of the cases were from the high-income and/or middle-income countries. 86.27% of the cases of HZ were reported due to mRNA vaccine. Thirty-six patients 36/45 (80%) developed herpes zoster following the priming dose of COVID-19 vaccine among those who received mRNA vaccine. CONCLUSION: We could not establish definite link but there may be possible association between COVID-19 vaccine and shingles. Large-scale studies may help to understand the cause-effect relationship.


Assuntos
COVID-19 , Varicela , Vacina contra Herpes Zoster , Herpes Zoster , Vacinas contra COVID-19 , Feminino , Herpes Zoster/epidemiologia , Herpes Zoster/prevenção & controle , Vacina contra Herpes Zoster/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2
9.
Rev Med Suisse ; 17(753): 1684-1689, 2021 Oct 06.
Artigo em Francês | MEDLINE | ID: mdl-34614308

RESUMO

The development of vesicles on the pinna and external auditory canal will often correspond to a herpes zoster infection of one of the many nerves innervating the external ear. In case of associated facial paralysis, vertigo or sudden deafness the patient should undergo a thorough neuro-otologic examination and receive appropriate treatment. This article proposes a reminder of the various clinical presentations of herpes zoster oticus with some neuro-anatomical considerations.


Assuntos
Herpes Zoster , Orelha Externa , Herpes Zoster/diagnóstico , Humanos
10.
BMJ Open ; 11(10): e045871, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625411

RESUMO

OBJECTIVES: To investigate the association between shingles and dementia, and between Zostavax vaccination and dementia. DESIGN: Nested case-control study. SETTINGS: Data were drawn from the UK Biobank cohort study with a total of 228 223 participants with Hospital Episodes Statistics and primary care linkage health records. PARTICIPANTS: The analyses included 2378 incident dementia cases and 225 845 controls. Inclusion criteria for incident cases were a dementia diagnosis 3 years or more after the first assessment date derived from all sources including International Classification of Diseases (ICD)-10, ICD-9, self-report and primary care linkage records. Subjects with no dementia code from all sources were coded as controls. Both shingles and Zostavax vaccination were investigated for their association with dementia risk. RESULTS: There was a small but non-significant increase in the risk of dementia in subjects with shingles diagnosed 3 years or more prior to dementia diagnosis (OR: 1.088 with 95% CI: 0.978 to 1.211). In those subjects who had had Zostavax vaccination, the risk of dementia significantly decreased (OR: 0.808 with 95% CI: 0.657 to 0.993). CONCLUSION: A history of shingles was not associated with an increased risk of dementia. In subjects who were eligible for the immunisation and vaccinated with Zostavax, we saw reduced risk of developing dementia.


Assuntos
Demência , Vacina contra Herpes Zoster , Herpes Zoster , Bancos de Espécimes Biológicos , Estudos de Casos e Controles , Estudos de Coortes , Demência/epidemiologia , Humanos , Reino Unido/epidemiologia , Vacinação
11.
In Vivo ; 35(6): 3271-3275, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34697158

RESUMO

Background/Αim: The relationship of herpes viruses and herpes zoster (HZ) with dementia and Alzheimer's disease is controversial. This study evaluated the relationship between HZ vaccination and cognitive impairment. PATIENTS AND METHODS: We used data from The Behavioral Risk Factor Surveillance System (BRFSS) to evaluate the relationship between HZ vaccination and cognitive impairment. RESULTS: Using BRFSS 2017 data, we assessed HZ vaccination status in 275 subjects whose social activities were hampered by disorientation or memory loss. 61.6% of vaccinated subjects (n=61) and 46.6% of unvaccinated subjects (n=82) never had social activities hampered by disorientation or memory loss. The result is significant (p=0.025, two- sided Fisher exact test). The results of multivariate linear regression analysis, considering social activities hampered by disorientation or memory loss as a dependent variable, and vaccination (yes or no), sex, and education level as independent variables, showed that the effect of vaccination--reducing risk of social activities hampered by disorientation or memory loss--was significant (p=0.03). CONCLUSION: Our finding that HZ vaccination reduces the risk of dementia is consistent with the link between viruses and AD. Herpes viruses-induced reactivation of embryologic pathways silenced at birth could be one of the pathologic processes in Alzheimer's disease.


Assuntos
Doença de Alzheimer , Herpes Zoster , Herpes Zoster/complicações , Herpes Zoster/epidemiologia , Herpes Zoster/prevenção & controle , Herpesvirus Humano 3 , Humanos , Recém-Nascido , Vacinação
12.
In Vivo ; 35(6): 3289-3296, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34697160

RESUMO

BACKGROUND/AIM: The importance of compliance with National Comprehensive Cancer Network (NCCN) guidelines for preventing varicella-zoster virus reactivation (VZVr) in multiple myeloma (MM) in a clinical setting has not been well investigated. PATIENTS AND METHODS: We retrospectively studied the clinical characteristics and outcomes of 118 patients with MM treated with proteasome inhibitors. RESULTS: Thirty-nine episodes of VZVr were observed in 37 patients (VZVr group). The proportion of prophylactic antiviral prescriptions and compliance with antiviral prophylaxis based on the NCCN Clinical Practice guidelines was 76% and 30% in the VZVr group, and 88% and 74% in the non-VZVr group, respectively. Multivariate analysis showed that compliance with the NCCN guidelines was the only independent risk factor for VZVr (p=0.0017). CONCLUSION: It is important that prophylactic antivirals are prescribed for an appropriate duration of time to prevent the reactivation of VZV in compliance with existing guidelines.


Assuntos
Herpes Zoster , Mieloma Múltiplo , Aciclovir/uso terapêutico , Antivirais/farmacologia , Antivirais/uso terapêutico , Herpes Zoster/tratamento farmacológico , Herpes Zoster/prevenção & controle , Herpesvirus Humano 3 , Humanos , Mieloma Múltiplo/tratamento farmacológico , Estudos Retrospectivos , Ativação Viral
13.
In Vivo ; 35(6): 3547-3553, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34697193

RESUMO

BACKGROUND/AIM: Oral cavity cancer is a major health problem worldwide. The herpes zoster vaccine is an effective method to protect against herpes zoster infection. In this study we aimed to determine the relationship between herpes zoster and oral cavity cancer. PATIENTS AND METHODS: The Longitudinal Generation Tracking Database in Taiwan was used to select oral and non-oral cavity cancer patients. The primary endpoint was herpes zoster. RESULTS: We included 3131 oral cavity cancer patients and 3131 non-oral cavity cancer patients. Patients with oral cavity cancer [adjusted hazard ratio (HR)=1.66, 95% confidence interval (CI)=1.27-2.16] had a significantly higher risk of herpes zoster compared to the control group. The oral cavity patients who received radiotherapy (adjusted HR=1.79, 95%CI=1.12-2.86) had a significantly higher risk of herpes zoster compared to the oral cavity patients who did not receive radiotherapy. CONCLUSION: Radiotherapy increases the incidence of herpes zoster infection in oral cavity cancer patients.


Assuntos
Herpes Zoster , Neoplasias Bucais , Estudos de Coortes , Herpes Zoster/epidemiologia , Humanos , Incidência , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/radioterapia , Estudos Retrospectivos , Taiwan/epidemiologia
14.
Emerg Med Clin North Am ; 39(4): 839-850, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34600641

RESUMO

Abdominal pain is a common reason for emergency department visits, with many patients not receiving a definitive diagnosis for their symptoms. Non-gastrointestinal causes need to be considered in the workup of abdominal pain. A high index of suspicion is needed in order to develop a broad differential, and a thorough history and physical examination is paramount. This article will discuss some of these diagnoses, including can't miss diagnoses, common non-abdominal causes, and rare etiologies of abdominal pain.


Assuntos
Dor Abdominal/etiologia , Síndrome Coronariana Aguda/diagnóstico , Doenças das Glândulas Suprarrenais/diagnóstico , Anemia Falciforme/diagnóstico , Angioedemas Hereditários/diagnóstico , Doenças da Aorta/diagnóstico , COVID-19/diagnóstico , Cetoacidose Diabética/diagnóstico , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Feminino , Insuficiência Cardíaca/complicações , Herpes Zoster/diagnóstico , Humanos , Intoxicação por Chumbo/diagnóstico , Transtornos de Enxaqueca/diagnóstico , Torção Ovariana/diagnóstico , Doença Inflamatória Pélvica/diagnóstico , Pneumonia/diagnóstico , Porfiria Aguda Intermitente/diagnóstico , Gravidez , Gravidez Ectópica/diagnóstico , Embolia Pulmonar/diagnóstico , Púrpura de Schoenlein-Henoch/diagnóstico , Tireotoxicose/diagnóstico , Uremia/diagnóstico
15.
Medicine (Baltimore) ; 100(40): e27368, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34622837

RESUMO

BACKGROUND: Biological therapy is effective for the treatment of psoriasis and psoriatic arthritis; however, adverse effects related to immunosuppression, such as viral infections, have been reported. Amongst these infections, herpes zoster (HZ) is common. OBJECTIVE: To evaluate the risk of HZ in psoriasis and psoriatic arthritis patients treated with biological therapy. DATA SOURCES: A comprehensive literature search of PubMed, Embase, and Web of Science was performed using certain keywords until October 9, 2020. Nine studies were included after a detailed assessment. STUDY ELIGIBILITY CRITERIA: The eligibility criteria included randomized controlled trials (RCTs) and observational studies of patients with psoriasis or psoriatic arthritis treated with biological therapies; compared with non-biological therapies, non-biological systemic therapies, or controls; with the incidence of HZ reported in case and control groups. The Cochrane risk of bias tool and Newcastle-Ottawa scale were used to assess the quality of the RCTs and observational studies, respectively. Data were extracted from 9 eligible studies and then analyzed using Stata software (Version 12.0). RESULTS: The risk of HZ in biological therapies was higher than that in non-biological (odds ratios [OR]: 1.48; 95% confidence interval [CI]: 1.18-1.86; I2 = 0%) and non-biological systemic (OR: 1.32; 95% CI: 1.02-1.71; I2 = 0%) therapies. Furthermore, the risk of HZ associated with tumor necrosis factor-α inhibitors increased significantly (OR: 1.50; 95% CI: 1.11-2.02; I2 = 0%). Notably, infliximab (OR: 2.43; 95% CI: 1.31-4.50; I2 = 0%) and etanercept (OR: 1.65; 95% CI: 1.07-2.56; I2 = 0%) increased the risk of HZ, while adalimumab (OR: 1.21; 95% CI: 0.64-2.30; I2 = 0%), ustekinumab (OR: 2.20; 95% CI: 0.89-5.44; I2 = 0%), alefacept (OR: 1.46; 95% CI: 0.20-10.47; I2 = 0%), and efalizumab (OR: 1.58; 95% CI: 0.22-11.34; I2 = 0%) did not. LIMITATIONS: Few RCTs have reported HZ incidents; thus, our results require confirmation via large-scale RCTs. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Biological therapies, especially tumor necrosis factor-α inhibitors, may lead to the risk of HZ in psoriasis and psoriatic arthritis patients. Amongst these agents, infliximab and etanercept have been shown to significantly increase the risk of HZ. Additionally, younger age and female sex may be risk factors. SYSTEMATIC REVIEW REGISTRATION NUMBER: INPLASY202110027.


Assuntos
Antirreumáticos/efeitos adversos , Artrite Psoriásica/tratamento farmacológico , Fatores Biológicos/efeitos adversos , Herpes Zoster/induzido quimicamente , Adulto , Idoso , Antirreumáticos/administração & dosagem , Fatores Biológicos/administração & dosagem , Feminino , Humanos , Imunossupressão/efeitos adversos , Imunossupressão/métodos , Masculino , Pessoa de Meia-Idade , Estudos Observacionais como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco
16.
Medicine (Baltimore) ; 100(37): e27293, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34664891

RESUMO

RATIONALE: Herpes zoster frequently causes dermatomal vesicular rash accompanied by severe neuralgia, and reaching a differential diagnosis may be challenging before the appearance of the vesicular rash. PATIENT CONCERNS: A 40-year-old male patient visited the emergency department with a complaint of sudden onset motor weakness and ipsilateral radiating neuralgia to the Lt. thigh. He had suffered from chickenpox during childhood. DIAGNOSES: No skin lesion was present at the initial visit. The reverse Straight Leg Raise test was negative. Magnetic resonance imaging showed asymmetrically swollen dorsal root ganglion with Gadolinium enhancement. The vesicular rash that appeared on the sixth day after the symptom onset led to the diagnosis of herpes zoster. INTERVENTIONS: Antiviral agent of valacyclovir (1000 mg t.i.d.) was administered for 7 days. OUTCOMES: The patient recovered from motor weaknesses by 2 weeks from the onset of the symptom. Mild degree post-herpetic neuralgia recovered by 2 months. LESSONS: A high index of suspicion is necessary to differentiate early herpes zoster radiculitis before the appearance of vesicular rash from compressive radiculopathy. In L2-3 ipsilateral radiating pain along the dermatome or myotome, the absence of reverse Straight Leg Raise sign may be a possible factor in differentiating herpes zoster radiculitis from compressive radiculopathy.


Assuntos
Herpes Zoster/complicações , Região Lombossacral/anormalidades , Paresia/etiologia , Radiculopatia/complicações , Adulto , Antivirais/farmacologia , Antivirais/uso terapêutico , Meios de Contraste/uso terapêutico , Gadolínio/uso terapêutico , Herpes Zoster/tratamento farmacológico , Herpes Zoster/fisiopatologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Paresia/tratamento farmacológico , República da Coreia , Valaciclovir/farmacologia , Valaciclovir/uso terapêutico
17.
BMJ Case Rep ; 14(10)2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34667049

RESUMO

Herpes zoster reactivation is a frequently encountered condition that can result in several uncommon complications. This case report highlights one such frequently overlooked complication, segmental zoster paresis. We discuss a case of prolonged fever and lower limb weakness in an immunocompromised patient with breast cancer on active chemotherapy after resolution of a herpetiform rash in the L2, L3 and L4 dermatomes. Early investigation with lumbar puncture, looking for cerebrospinal fluid pleocytosis, varicella zoster virus detection by PCR or molecular testing and immunoglobulins against varicella zoster virus, should be undertaken to support the diagnosis. Nerve conduction studies, electromyography and MRI of the spine can sometimes help with neurolocalisation. Intravenous acyclovir and a tapering course of steroids can help with resolution of symptoms. The variegate presentation can make diagnosis challenging. Awareness and a high index of suspicion can prevent delays in diagnosis and treatment and improve patient outcomes.


Assuntos
Herpes Zoster , Aciclovir/uso terapêutico , Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Herpes Zoster/tratamento farmacológico , Herpesvirus Humano 3 , Humanos , Hospedeiro Imunocomprometido , Paresia/etiologia
18.
Clin J Pain ; 37(12): 867-871, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34593674

RESUMO

OBJECTIVES: The purpose of this study was to observe the effect of subcutaneous stimulation of the peripheral nerve on acute or subacute zoster occurring in trigeminal nerve branches, and to evaluate the preventive effect of prior temporary implant of a peripheral stimulation electrode in the acute or subacute phase of herpes zoster (HZ) (from 30 to 90 d after zoster onset) before postherpetic neuralgia (PHN) presents. METHODS AND MATERIALS: A total of 26 patients' medical records were analyzed. All of patients had received temporary subcutaneous peripheral nerve stimulation (PNS). The clinical efficacy of treatment was evaluated on a visual analog scale (VAS), and dosages of pain medication were recorded before and at 1 to 6 months after the temporary stimulation. The rate of PHN was reevaluated at a 6 months follow-up. RESULTS: There was a significant decrease in VAS values after PNS. Medication doses decreased significantly after TPNS. The rate of clinically meaningful PHN (VAS >3) dropped below 4%. DISCUSSION: This study revealed that PNS is an effective treatment for trigeminal herpetic neuralgia following acute or subacute HZ. As a extend neuromodulation method, subcutaneous peripheral nerve-field stimulation might be a useful option to reduce the progression of neuropathic changes caused by persistent transmission of pain signals in the trigeminal nerve branches after the acute or subacute phase of HZ.


Assuntos
Herpes Zoster , Neuralgia Pós-Herpética , Neuralgia do Trigêmeo , Herpes Zoster/complicações , Herpes Zoster/terapia , Humanos , Neuralgia Pós-Herpética/tratamento farmacológico , Nervos Periféricos , Estudos Retrospectivos , Neuralgia do Trigêmeo/terapia
20.
BMC Infect Dis ; 21(1): 963, 2021 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-34530756

RESUMO

BACKGROUND: Varicella-zoster virus (VZV) infection may induce central nervous system complications in HIV/AIDS patients. However, it is rare to have paraplegia caused by VZV infection but no herpes zoster clinically. Asymptomatic VZV infection in HIV/AIDS patient increased the difficulty of diagnosis. CASE PRESENTATION: We reported a 41-year-old male AIDS patient with rare asymptomatic VZV infection-induced paraplegia after his anti-retroviral therapy initiation. MRI of the spinal cord showed the morphology of the thoracic spinal cord was irregular and locally inflated. The patient was confirmed as VZV induced thoracic myelomyelitis by using the cerebrospinal fluid for metagenomic next-generation sequencing (mNGS). CONCLUSIONS: mNGS may contribute to disease diagnosis for asymptomatic VZV infection-induced myelitis.


Assuntos
Síndrome de Imunodeficiência Adquirida , Herpes Zoster , Infecção pelo Vírus da Varicela-Zoster , Adulto , Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Herpesvirus Humano 3/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Paraplegia/diagnóstico , Infecção pelo Vírus da Varicela-Zoster/complicações , Infecção pelo Vírus da Varicela-Zoster/diagnóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...