Herpes Zoster is caused by reactivation of latent VaricellaZosterVirus (VZV) in sensory nerve ganglia. Aging and immunosuppressive conditions result in a decline in VZV- specific cell mediated immunity that predisposes to zoster. It presents as a distinctive, painful vesicular rash appearing in a unilateral, dermatomal distribution and post-herpetic neuralgia is the most common complication of this disease. Treatment of herpes zoster and post-herpetic neuralgia is complex. The vaccine for the prevention of herpes zoster has been licensed for individuals 60 years of age and older,
Aims: To evaluate the performance of a varicella-zostervirus (VZV) pathway in different Emergency Departments (ED). Design: Observational prospective multicenter study in 49 EDs (local, reference and intermediate EDs). The subjects of the study were patients older than 14 years with a clinical diagnosis of varicella or herpes who were assisted at all EDs during the whole study period (Feb-Jul 2007). Data on demographic, clinical characteristics and application of CP were recorded. Acceptance of CP was assessed by survey.
Introduction: Necrotizing vasculitis of the central nervous system due to varicellazostervirus (VZV) infection implicates an infrequent entity due to direct invasion of the blood vessels. The objective is to present t h e c l i n i c a l c a s e o f a p a r e n c h y m a l h e m o r r h a g e associated with herpes zoster cerebral vasculitis. Case report: A 19-year-old man with history of recent VZV i n f e c t i o n p r e s e n t s w i t h s e v e r e h e a d a c h e , l e f t hemiparesis, a Glasgow coma scale of 9 points, right anisocoria secondary to parenchymal hemorrhage. The histopathological diagnosis was compatible with viral necrotizing vasculitis. Conclusions: Cerebral vasculitis is a rare cause of intracranial hemorrhage that should be suspected in a patient with history of recent VVZ infection. Magnetic resonance imaging and conventional angiography studies are useful elements in the diagnosis; however, they are poor indicators of the presence or vasculitis. Thus, the diagnosis does not r e l y o n a s i n g l e m e t h o d , b u t o n t h e c l i n i c a l , imagenological and histopathological correlation.
H erpes Zoster (Herpes Zona, St. Anthony’s fire, and a number of further epitopic designations) is caused by the reactivation of the Varicella-ZosterVirus (VZV), lodged in latent form in the ganglia of the posterior radices of the medulla. Its incidence is ca. 3 cases per thousand inhabitants and year, and it does increase with age. It does preferently involve the thoracic dermatomata, and the presence –the apparition– of the typical erythematovesicular lesion with metameric distribution privides the diagnosis of Herpes Zoster. The location of the condition in the external auditive duct and in the first trigeminal branch are particularly dangeorus, as they involve the possibility of otic and/or ocular complications. The most frequent complication is trigeminal neu- ralgia, most probable among the aged and when the trigeminal root is involved, with more protracted pre-eruptive phase or more intense pain. The aims and objectives of therapy in Herpes Zoster are to manage pain and the other symptoms in the acute phase, to abbreviate the du- ration of the disease, to prevent the appearance of complications (par- ticulary post-herpetic neuralgia), to manage complications when and where they occur, and to prevent contagion. Oral antiviral agents repre- sent the most effective medical therapy measure for preventing compli- cations. Efficacy in prevention and therapy of complications. Efficacy in prevention and therapy of complications, comfort of administration and experience with its use render valaciclovir the prime and first alternati- ve in selecting the antiviral agent to be used in most instances.
6- Gilden DH, Kleinschmidt-de Masters BK, LaGuardia JJ, Mahalingam R, Cohrs RJ. Neurologic complications of the reactivation of varicella-zostervirus. N Eng J Med 2000;342:635-45. 7- Picazo de la Garza JJ, Abad Cervero P, Moya Mir M. Estudio epidemiológico nacional sobre herpes zoster en Espa- ña. Incidencia, manifestaciones cínicas y evolución. Madrid. TCC. 1999. 8- Bayu S, Alemayehu W. Clinical prolfi- le of herpes zoster ophtalmicus in ethio- pians. Clin Infect Dis 1997;24:1256-60. 9- Whitley RJ. Varicella-zostervirus. En Madell GL, Douglas RG, Bennett JE. Principles and Practice of Infectious Di- seases. 3ª ed.. New York. Churchill Li- vingtone 1995. P 1345-51.
Background: Herpes Zoster is a disease caused by the varicellazostervirus, which causes chickenpox. After having had this pathology the virus remains in the body. It may not cause problems for many years; it is more common in people over 50 years of age. Objective: To identify varicellavirus causing Herpes Zoster, in older adults of the geriatric center Divino Niño city of Jipijapa. Methods and techniques: Analytical and descriptive methods were used as well as techniques such as direct observation and survey. The study sample consisted of 45 elderly people of the gerontological center distributed as follows: 24 men corresponding to 53.33% and 21 women corresponding to 46.67%. Results: Antibodies were detected in the blood samples analyzed by the microelisa method. For the detection of IgG antibody, 1 geriatric corresponding to 2.22% gave negative result and 44 corresponding to 97.78% gave positive result for VaricellaVirus, the ages with the highest prevalence were 75 to 79 years. For geriatric IgM 5 antibodies that corresponded to 11.11% gave a positive result and 40 that corresponded to 88.89% negative, showing that 5 older adults present Herpes Zoster with 3 men and 2 women. Conclusions: The elderly population is prone to recurrent infections. This is why it is suggested that anti-t zostervaricella be detected in this vulnerable group. Also follow up in cases for the control and prevention of the disease.
Chickenspox is the common presentation of the infection with varicellazostervirus which generally affects children and usually has a benign course. In developed countries less than 5 % of the cases occur in adults with higher index of complications and elevated mortality. The heart affectation is unusual and practically exclusive in children, mainly having immunological deficiency. A clinical case was studied of a 49 year-old patient who presented episode of precordial chest pain suggestive of myocardial ischemia, in the context of an infection with varicellazostervirus. The patient mentioned above was prescribed thrombolytic and pharmacological therapy of acute myocardial infarction in the Emergency Medicine Department. The angiographic study showed no lesions. In the evolution of the echocardiography, recovery of the cardiovascular functional parameters was evidenced, being suggested the definitive diagnosis of myocarditis by varicellazostervirus.
Herpes zoster is a skin disease caused by re- activation of latent varicellazostervirus in the sensory ganglia dorsal root. The incidence in- creases significantly in HIV positive patients. In these patients, it can be seen more affection, with necrotic lesions and dissemination, tends to be persistent, with a torpid clinical course, and has a higher rate of complications. This paper reports a brief review of the literature and presents two cases of herpes zoster as the first manifestation of infection with the HIV.
HIV infection makes HIV carriers susceptible to develop a group of infections that would not normally be found in an immunocompetent patient. In Colombia, a total of 11,606 cases of HIV infection were reported in 2015. This paper documents the case of a patient diagnosed with HIV infection, who developed lesions typically caused by the varicella- zostervirus. These vesicular lesions evolved into phlyctenas with local necrosis. Given the case presentation, the diagnosis of skin lesions in immunocompromised or HIV-infected patients becomes a challenge for health professionals when determining an etiological diagnosis, in order to establish an appropriate treatment.
T he varicella-zostervirus is a member of the Herpesvi- ridae family, alpha-herpesvirinae subfamily. The viral replication process is reviewed, which has the particu- larly of destroying the host cell where it occurs. The main aspects of the pathogenesis of herpes zoster that may have an impact on the management of the disease (latency and reactivation) are examined. The various antiviral drugs used until the introduction of the new oral antivirals are exami- ned, and particular emphasis is made on famcyclovir. This drug, with a better bioavailability than acyclovir, allows for a more convenient therapeutic schedule with similar or even better therapeutic efficacy, particularly in the elimina- tion of the zoster-associated pain.
Objective: to show the clinical manifestations evidence, complications and ophthalmic sequels in a patient with an ophthalmic herpes zoster diagnosis. Case Presentation: a male patient of 75 years old with personal medical records of varicella in the childhood, he goes to outpatient service because of lacrimation, photophobia and great palpebral edema in his right eye, accompanied by clear watery vesicles and scabs in skin of the forehead and nose. The ophthalmic exam evidences severe ciliary and conjunctival injection, dendritic keratitis, corneal endothelial plaques and positive Hutchinson's sign. It was diagnosed as
Incident cases were defined as subjects recruited at the investigator’s office for a current zoster episode which had a duration of equal or less than 7 days. Prevalent cases were defined as patients enrolled while visiting the investigator for a current zoster episode which lasted longer than 7 days and for which the onset of rash had been recorded in the medical records. The onset of disease was defined by the zoster rash onset date rather than the date of cohort entry.
T he author critically reviews the therapy of herpes zoster and its management in the Emergency Clinic setting. The aims of the therapeutic measures are: (1) to alleviate the symptoms of the acute phase; (2) to shorten the duration of that phase; (3) to prevent the apparition of complications, and particularly of postherpetic neuralgia; (4) to treat the complica- tions when they appear, and (5) to prevent contagion. The main decision to be made is whether or not to use oral antiviral agents (famcyclovir, valacyclovir, and acyclovir). These should be used when the patient is over 55 years of age, when there is moderate immunodepresion, when there is intense pain in the acute phase and when otic or ocular complications arise. The alternatives with the most comfortable schedules for the first two situations are famcyclovir 250 mg q. 8 h., valacyclovir 1000 mg q. 8 h., or famcyclovir 750 mg q. d. Corticosteroids are also useful for shortening the duration of the acute phase and reducing the intensity of pain. Intravenous acyclovir should be given in the case of neurological complications, cu- taneous dissemination or severe immunodepression.
The system of naming herpes viruses was originated in 1973 and has been elaborated considerably since. The recommended naming system specified that each herpes virus should be named after the taxon (family or subfamily) to which its primary natural host belongs. The subfamily name is used for viruses from members of the family Bovidae or from primates (the virus name ending in –ine, e.g. bovine) and the host family name for other viruses (ending in –id, e.g. equid). Human herpes viruses have been treated as an exception (human rather than hominid). Following the host-derived term, the word herpes virus is added, followed by an Arabic numeral (1,2,3,...). These last two additions bear no implied meaning about taxonomic or biological properties of the virus.
ralmente comienza con dolor, muy frecuente en esta forma clí- nica, junto a lagrimeo, fotofobia y conjuntivitis (Figura 7). La erupción cutánea puede extenderse desde la región ocular hasta el vertex craneal, pero respetando la línea media. Aparece erite- ma y sobre él se desarrollan las pápulas, vesículas y costras de forma habitual. Los parpados se edematizan llegando a dificul- tar la apertura palpebral. A veces, a pesar de que la afectación es unilateral, los párpados del ojo contralateral también se alte- ran, sin que esto signifique que exista diseminación del herpes (Figura 8). Sin embargo, la presencia de lesiones herpéticas en Figura 8. Herpes zoster oftálmico: a pesar de que la afectación es unilateral, se observa edema de los párpados del ojo contralateral.
La presentación de vasculitis necrotizante del sistema nervioso central secundaria a infección viral por varicela Zoster constituye una rara pero conocida entidad, resultado de la invasión directa de los vasos sanguíneos. Objetivo: dar a conocer el caso clínico de una hemorragia parenquimatosa como resultado de una vasculitis cerebral por varicela zoster. Caso clínico: paciente masculino de 19 años de edad con antecedente de infección primaria por virus varicela zoster, a su ingreso con céfalea súbita de severa intensidad, hemiparesia izquierda, glasgow de 9 puntos, anisocoria a expensas de púpila derecha secundarios a hemorragia parenquimatosa y diagnóstico histopatológico de vasculitis necrotizante por varicela zoster. Conclusiones: la vasculopatía cerebral como complicación de Zoster cráneo-cervical explica la diversidad de desórdenes clínicos asociados con el virus. La vasculitis cerebral constituye una causa rara de hemorragia intracraneana que debe ser sospecha en un paciente con historia de infección reciente por virus varicela Zoster. Los estudios de resonancia magnética y angiografía convencional son elementos útiles en el diagnóstico; sin embargo, son pobres indicadores de la presencia o ausencia de vasculitis, por lo que el diagnóstico no depende de un método por sí sólo, sino de la correlación clínica, imagenológica e histopatológica.
8. Efectividad del tratamiento acupuntural del herpes zoster en pacientes del consultorio Punta de Mulatos. En: Rodríguez Ardines C A, González Fernández J, III Congreso Regional de Medicina Familiar Wonca Iberoamericana CIMF, X Seminario Internacional de Atención Primaria de Salud. Venezuela 2011; Versión Virtual 9. Biswas J, Sudharshan S. Anterior segment manifestations of human