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Navarro-Triviño FJ, Guerrero Fernández de Alba I. Link Between Dermatology and Preventive Medicine: Has the Shingles Vaccination Changed the Overall Landscape? ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00421-6. [PMID: 38768809 DOI: 10.1016/j.ad.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/04/2024] [Accepted: 04/14/2024] [Indexed: 05/22/2024] Open
Affiliation(s)
- F J Navarro-Triviño
- Unidad de Eczema de Contacto e Inmunoalergia Cutánea, Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, España; Instituto de Investigación Biosanitaria, Hospital Universitario San Cecilio, Granada, España.
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Tang S, Hu W, Zou H, Luo Q, Deng W, Cao S. The complement system: a potential target for the comorbidity of chronic pain and depression. Korean J Pain 2024; 37:91-106. [PMID: 38433474 PMCID: PMC10985490 DOI: 10.3344/kjp.23284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/28/2023] [Accepted: 12/16/2023] [Indexed: 03/05/2024] Open
Abstract
The mechanisms of the chronic pain and depression comorbidity have gained significant attention in recent years. The complement system, widely involved in central nervous system diseases and mediating non-specific immune mechanisms in the body, remains incompletely understood in its involvement in the comorbidity mechanisms of chronic pain and depression. This review aims to consolidate the findings from recent studies on the complement system in chronic pain and depression, proposing that it may serve as a promising shared therapeutic target for both conditions. Complement proteins C1q, C3, C5, as well as their cleavage products C3a and C5a, along with the associated receptors C3aR, CR3, and C5aR, are believed to have significant implications in the comorbid mechanism. The primary potential mechanisms encompass the involvement of the complement cascade C1q/C3-CR3 in the activation of microglia and synaptic pruning in the amygdala and hippocampus, the role of complement cascade C3/C3a-C3aR in the interaction between astrocytes and microglia, leading to synaptic pruning, and the C3a-C3aR axis and C5a-C5aR axis to trigger inflammation within the central nervous system. We focus on studies on the role of the complement system in the comorbid mechanisms of chronic pain and depression.
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Affiliation(s)
- Shanshan Tang
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Wen Hu
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Helin Zou
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Qingyang Luo
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Wenwen Deng
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Song Cao
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical University, Zunyi, China
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Sanchez G, Tsougranis G, Zheng H, Miller DM, Phan C, Jeng BH, Cohen E, Zegans ME. Out of sight, but not out of mind: Zoster sine herpete case study and survey of Zoster Eye Disease Study (ZEDS) Group. Am J Ophthalmol Case Rep 2024; 33:101978. [PMID: 38261902 PMCID: PMC10797137 DOI: 10.1016/j.ajoc.2023.101978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 11/06/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024] Open
Affiliation(s)
- George Sanchez
- Section of Ophthalmology, Dartmouth-Hitchcock Medical Center, NH, Lebanon
| | - Gregory Tsougranis
- Section of Ophthalmology, Dartmouth-Hitchcock Medical Center, NH, Lebanon
| | - Heavenly Zheng
- Section of Ophthalmology, Dartmouth-Hitchcock Medical Center, NH, Lebanon
| | - Donald M. Miller
- Section of Ophthalmology, Dartmouth-Hitchcock Medical Center, NH, Lebanon
| | - Cong Phan
- Section of Ophthalmology, Dartmouth-Hitchcock Medical Center, NH, Lebanon
| | - Bennie H. Jeng
- Dept. of Ophthalmology/Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Elisabeth Cohen
- Dept. of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Michael E. Zegans
- Section of Ophthalmology, Dartmouth-Hitchcock Medical Center, NH, Lebanon
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Mehrmal S, Mojica R, Guo AM, Missall TA. Diagnostic Methods and Management Strategies of Herpes Simplex and Herpes Zoster Infections. Clin Geriatr Med 2024; 40:147-175. [PMID: 38000858 DOI: 10.1016/j.cger.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
Herpesviruses are medium-sized double-stranded DNA viruses. Of more than 80 herpesviruses identified, only 9 human herpesviruses have been found to cause infection in humans. These include herpes simplex viruses 1 and 2 (HSV-1 and HSV-2), varicella-zoster virus (VZV), human cyto-megalovirus (HCMV), Epstein-Barr virus (EBV), and human herpesvirus (HHV-6A, HHV-6B, HHV-7, HHV-8). HSV-1, HSV-2, and VZV can be problematic given their characteristic neurotropism which is the ability to invade via fusion of its plasma membrane and reside within neural tissue. HSV and VZV primarily infect mucocutaneous surfaces and remain latent in the dorsal root ganglia for a host's entire life. Reactivation causes either asymptomatic shedding of virus or clinical manifestation of vesicular lesions. The clinical presentation is influenced by the portal of entry, the immune status of the host, and whether the infection is primary or recurrent. Affecting 60% to 95% of adults, herpesvirus-associated infections include gingivostomatitis, orofacial and genital herpes,and primary varicella and herpes zoster. Symptomatology, treatment, and potential complications vary based on primary and recurrent infections as well as the patient's immune status.
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Affiliation(s)
- Sino Mehrmal
- Department of Dermatology, Saint Louis University School of Medicine, 1225 South Grand Boulevard, Saint Louis, MO 63104, USA
| | - Rafael Mojica
- Department of Dermatology, University of Florida College of Medicine, 4037 Northwest 86th Terrace, Gainesville, FL 32606, USA
| | - Aibing Mary Guo
- Department of Dermatology, Saint Louis University School of Medicine, 1225 South Grand Boulevard, Saint Louis, MO 63104, USA
| | - Tricia A Missall
- Department of Dermatology, University of Florida College of Medicine, 4037 Northwest 86th Terrace, Gainesville, FL 32606, USA.
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Nomura H, Iwasaki H, Nomura S, Tanaka Y. Simultaneous herpes zoster rash in the femoral and medial buttock region that illustrates the innervation zone of the dorsal ramus of the lumbar spinal nerve root: A case report. J Orthop Sci 2024; 29:399-401. [PMID: 35691877 DOI: 10.1016/j.jos.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/30/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Hiroshi Nomura
- Nomura Orthopaedic Clinic, Address: 4-8-1 Ayaragihon-machi, Shimonoseki, Yamaguchi 751-0849 Japan.
| | - Hiroshi Iwasaki
- Department of Orthopedic Surgery, Wakayama Medical University, Address: 811-1 Kimiidera, Wakayama, Wakayama 641-8509 Japan
| | - Shigeharu Nomura
- Nomura Orthopaedic Clinic, Address: 4-8-1 Ayaragihon-machi, Shimonoseki, Yamaguchi 751-0849 Japan
| | - Yasuhisa Tanaka
- Department of Orthopedic Surgery, Tohoku Central Hospital, Yamagata, Japan, Address: 3-2-5 Wagou-machi, Yamagata, Yamagata 990-8510 Japan
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Yale SH, Tekiner H, Yale ES. Jugular Forman syndrome as described by Vernet. Neurohospitalist 2024; 14:112-113. [PMID: 38235020 PMCID: PMC10790619 DOI: 10.1177/19418744231195684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Affiliation(s)
- Steven H. Yale
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Halil Tekiner
- Department of the History of Medicine and Ethics, School of Medicine, Erciyes University, Melikgazi, Turkey
| | - Eileen S. Yale
- Division of General Internal Medicine, University of Florida, Gainesville, FL, USA
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Wang X, Chen H, Song F, Zuo K, Chen X, Zhang X, Liang L, Ta Q, Zhang L, Li J. Resveratrol: a potential medication for the prevention and treatment of varicella zoster virus-induced ischemic stroke. Eur J Med Res 2023; 28:400. [PMID: 37794518 PMCID: PMC10552394 DOI: 10.1186/s40001-023-01291-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Infection rate of varicella zoster virus (VZV) is 95% in humans, and VZV infection is strongly associated with ischemic stroke (IS). However, the underlying molecular mechanisms of VZV-induced IS are still unclear, and there are no effective agents to treat and prevent VZV-induced IS. OBJECTIVE By integrating bioinformatics, this study explored the interactions between VZV and IS and potential medication to treat and prevent VZV-induced IS. METHODS In this study, the VZV and IS datasets from the GEO database were used to specify the common genes. Then, bioinformatics analysis including Gene Ontology, Kyoto Encyclopedia Genes Genomes and Protein-Protein Interaction network analysis was performed. Further, the hub genes, transcription factor (TF) gene interactions, TF-miRNA co-regulatory network and potential drug were obtained. Finally, validation was performed using molecular docking and molecular dynamics simulations. RESULTS The potential molecular mechanisms of VZV-induced IS were studied using multiple bioinformatics tools. Ten hub genes were COL1A2, DCN, PDGFRB, ACTA2, etc. TF genes and miRNAs included JUN, FOS, CREB, BRCA1, PPARG, STAT3, miR-29, etc. A series of mechanism may be involved, such as inflammation, oxidative stress, blood-brain barrier disruption, foam cell generation and among others. Finally, we proposed resveratrol as a potential therapeutic medicine for the prevention and treatment of VZV-induced IS. Molecular docking and molecular dynamics results showed that resveratrol and hub genes exhibited strong binding score. CONCLUSIONS Resveratrol could be an alternative for the prevention and treatment of VZV-IS. More in vivo and in vitro studies are needed in the future to fully explore the molecular mechanisms between VZV and IS and for medication development.
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Affiliation(s)
- Xu Wang
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Hao Chen
- Department of Neurovascular Surgery, First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Feiyu Song
- Jilin Connell Pharmaceutical Co., Ltd, JilinJilin, 132013, China
| | - Kuiyang Zuo
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Xin Chen
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Xu Zhang
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Lanqian Liang
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Qiyi Ta
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Lin Zhang
- China-Japan Union Hospital of Jilin University, Changchun, 130021, Jilin, China.
| | - Jinhua Li
- School of Public Health, Jilin University, Changchun, 130021, Jilin, China.
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Wang A, Niu Y, Zhao J, Liu H, Ding P, Chen Y, Zhou J, Zhu X, Zhang Y, Liang C, Zhang G. Rapid detection of varicella-zoster virus based on an immunochromatographic strip. Virology 2023; 586:35-42. [PMID: 37481958 DOI: 10.1016/j.virol.2023.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/26/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
Varicella-zoster virus (VZV) is a highly infectious DNA virus that can cause varicella (chickenpox) and herpes zoster (HZ). A simple, sensitive and specific detection method is desirable for the VZV infection. In this study, VZV gE protein, expressed in CHO cells, was used to immunize BALB/c mice for the generation of monoclonal antibodies (mAbs). For the first time, we developed a colloidal gold-based immunochromatographic strip for rapid detection of VZV using a pair of mAbs against gE protein. The limit of detection (LOD) of the strip was 30 ng mL-1 of purified VZV gE antigen, and it could specifically test VZV without cross-reactivity with Enterovirus 71 (EV-71), Herpes simplex virus 1 (HSV-1) and Herpes simplex virus 2 (HSV-2). The coincidence rate between the strip and commercial real-time PCR diagnostic kit was 100% using vesicle as the clinical sample. Our strip provided a technical support for rapid and specific detection of VZV.
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Affiliation(s)
- Aiping Wang
- Henan Longhu Modern Immunity Laboratory, Zhengzhou, Henan, China; School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan Niu
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Jianguo Zhao
- Henan Longhu Modern Immunity Laboratory, Zhengzhou, Henan, China; College of Agriculture, Peking University, Beijing, China
| | - Hongliang Liu
- Henan Longhu Modern Immunity Laboratory, Zhengzhou, Henan, China; School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Peiyang Ding
- Henan Longhu Modern Immunity Laboratory, Zhengzhou, Henan, China; School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yumei Chen
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Jingming Zhou
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Xifang Zhu
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Ying Zhang
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Chao Liang
- School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Gaiping Zhang
- Henan Longhu Modern Immunity Laboratory, Zhengzhou, Henan, China; School of Life Sciences, Zhengzhou University, Zhengzhou, Henan, China; College of Agriculture, Peking University, Beijing, China.
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Fan HR, Zhang EM, Fei Y, Huang B, Yao M. Early Diagnosis of Herpes Zoster Neuralgia: A Narrative Review. Pain Ther 2023; 12:893-901. [PMID: 37129752 PMCID: PMC10289968 DOI: 10.1007/s40122-023-00510-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/30/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Early intervention reduces the incidence of postherpetic neuralgia (PHN). Typical shingles are easy to diagnose; however, there is no clear diagnostic method for neuralgia symptoms manifested before the onset of the rash, which can easily cause misdiagnosis. This not only increases the patient's pain, medical expenses, and mental burden, but more importantly, delays the valuable time for early treatment of shingles, and increases the probability of complications and PHN. OBJECTIVE In this paper, the diagnostic methods of preherpetic neuralgia were summarized and analyzed, and the current challenges were put forward to provide directions for the early diagnosis of herpes zoster (HZ) in the future. METHODS PubMed, and China National Knowledge Infrastructure (CNKI) libraries were searched using the terms "herpes zoster," "before the blistering," "diagnosis," and "neuralgia." Clinical trials, reviews, and case reports were collected and reviewed. The period of literature search is from 1 January 1980 to 1 October 2022. RESULTS The early diagnosis of herpes zoster neuralgia can reduce misdiagnosis and mistreatment, and timely and effective intervention can significantly reduce the incidence of PHN. The body may possess a mechanism that limits the local breakthrough of the virus in the skin, causing blistering later than the onset of pain. Changes in the plasma proteins of patients with varicella-zoster virus shingles neuralgia may be used as an early diagnostic indicator in patients with HZ neuralgia before eruption. CONCLUSION Early diagnosis of HZ neuralgia before eruption can facilitate timely targeted treatment, thereby reducing the incidence of PHN. Proteomic quantitative analysis and validation results can serve as a simple, micro, rapid, and accurate diagnostic method.
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Affiliation(s)
- Han-Rui Fan
- Zhejiang Chinese Medicine University, Hangzhou, People's Republic of China
| | - En-Ming Zhang
- Zhejiang Chinese Medicine University, Hangzhou, People's Republic of China
| | - Yong Fei
- Department of Anesthesiology and Pain, The Affiliated Hospital of Jiaxing University, 1882 Zhong-Huan-South Road, Jiaxing, 314000, People's Republic of China.
| | - Bing Huang
- Department of Anesthesiology and Pain, The Affiliated Hospital of Jiaxing University, 1882 Zhong-Huan-South Road, Jiaxing, 314000, People's Republic of China
| | - Ming Yao
- Department of Anesthesiology and Pain, The Affiliated Hospital of Jiaxing University, 1882 Zhong-Huan-South Road, Jiaxing, 314000, People's Republic of China
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Xie S, Yang X, Xia H, Lai J, Liu Q, Lu Z, He D, Liu X. Clinical features of varicella-zoster virus caused neurological diseases detected by metagenomic next-generation sequencing. Open Med (Wars) 2023; 18:20230744. [PMID: 37465353 PMCID: PMC10350883 DOI: 10.1515/med-2023-0744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 07/20/2023] Open
Abstract
Clinical presentation of central nervous system (CNS) infections caused by varicella-zoster virus (VZV) is highly sophisticated, making identification challenging. We retrospectively reported 18 cases of VZV neurologic disease confirmed by metagenomic next-generation sequencing (mNGS). The detection rate of mNGS was higher than that of PCR assay (100 vs 66.7%, p < 0.05) and serum IgM antibody (100 vs 68.8%, p < 0.05) measurement. Of the 18 cases, five patients were diagnosed with acute meningitis, three with acute meningitis combined with facial neuritis, three with acute meningitis combined with polycranial neuritis, and the remaining seven with various clinical diagnoses. Typical clinical symptoms included headache (15), fever (9), and rash (11). Cranial or spinal MRI showed abnormalities in 12 patients, and 17 patients had obvious neurological symptoms. The predominant genotype of VZV in this study was genotype J (100%, 10/10). All patients were treated with acyclovir/penciclovir and dexamethasone, 16 recovered and 2 died. Our study highlights the good performance of mNGS in diagnosing CNS infection caused by VZV. It could provide additional diagnostic evidence in patients with diverse clinical spectrum and variable manifestations.
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Affiliation(s)
- Shuhua Xie
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Xuying Yang
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, 100000, China
| | - Han Xia
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, 100000, China
| | - Jinxing Lai
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Qing Liu
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Zhijuan Lu
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Dehai He
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
| | - Xianghong Liu
- Department of Neurology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, 341000, China
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McKenzie I, Tsarfati EM. Lyme radiculopathy in a septuagenarian. BMJ Case Rep 2023; 16:e251982. [PMID: 37270176 PMCID: PMC10255208 DOI: 10.1136/bcr-2022-251982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
A man in his 70s presented to hospital in early summer with a 5-week history of progressive lower back and right thigh pain, sensory deficit and right leg weakness. There had been limited response to analgesics in the community. Primary investigations on admission revealed no cause for his symptoms. Five days into admission, history emerged of a possible tick bite with subsequent rash sustained 3 months earlier, raising the possibility of neuroborreliosis leading to radiculopathy. Cerebrospinal fluid demonstrated a lymphocytic pleocytosis. An elevated Borrelia burgdorferi antibody index confirmed a diagnosis of Lyme neuroborreliosis. The patient was treated successfully with 28 days of intravenous ceftriaxone, analgesia and physiotherapy. Within the literature, Lyme radiculopathy is a common presentation of neuroborreliosis and should be considered and investigated in patients without radiological evidence of a mechanical cause of worsening lower back pain in settings with endemic Lyme disease.
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Yang Y, Mahmood T, Siddiqui AH, Aziz MA. Zoster Sine Herpete: two unusual cases of varicella-zoster reactivation with atypical complaints of acute chest pain and severe headache. BMC Infect Dis 2023; 23:239. [PMID: 37072696 PMCID: PMC10111296 DOI: 10.1186/s12879-023-08093-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/16/2023] [Indexed: 04/20/2023] Open
Abstract
In this case report, we describe two unusual presentations of varicella-zoster virus (VZV) reactivation without rash, a condition known as Zoster Sine Herpete (ZSH). In Case 1, a 58-year-old woman presented with severe right-sided chest pain under her breast that radiated to the ipsilateral back. After the initial workup ruled out cardiac and musculoskeletal etiologies, the characteristic dermatomal distribution of pain made us suspect VZV reactivation. A diagnosis of ZSH was made with positive VZV IgG and IgM serologies and symptomatic relief after famciclovir treatment. In Case 2, a 43-year-old woman presented with a severe headache and resolved sharp right flank pain. She was diagnosed with varicella meningitis after cerebrospinal fluid showed positive VZV DNA. Intravenous acyclovir treatment resulted in symptom resolution. The most common presentation of VZV reactivation is Herpes Zoster, or shingles, making ZSH a frequently missed diagnosis. High clinical suspicion is warranted to prevent life-threatening complications of ZSH.
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Affiliation(s)
- Yilin Yang
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Talha Mahmood
- Biological Sciences, Florida International University, Miami, FL, USA
| | - Afsheen H Siddiqui
- Johns Hopkins Community Physicians, CIMS Hospitalist, Howard County General Hospital, Johns Hopkins Medicine, 5755 Cedar Lane, Columbia, MD, 21044, USA
| | - Muhammad A Aziz
- Johns Hopkins Community Physicians, CIMS Hospitalist, Howard County General Hospital, Johns Hopkins Medicine, 5755 Cedar Lane, Columbia, MD, 21044, USA.
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13
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Cho SY, Jang BH, Seo JW, Kim SW, Lim KJ, Lee HY, Kim DJ. Transverse myelitis caused by herpes zoster following COVID-19 vaccination: A case report. World J Clin Cases 2023; 11:1419-1425. [PMID: 36926132 PMCID: PMC10013101 DOI: 10.12998/wjcc.v11.i6.1419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/17/2023] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Transverse myelitis (TM) is characterized by sudden lower extremity progressive weakness and sensory impairment, and most patients have a history of advanced viral infection symptoms. A variety of disorders can cause TM in association with viral or nonviral infection, vascular, neoplasia, collagen vascular, and iatrogenic, such as vaccination. Vaccination has become common through the global implementation against coronavirus disease 2019 (COVID-19) and reported complications like herpes zoster (HZ) activation has increased.
CASE SUMMARY This is a 68-year-old woman who developed multiple pustules and scabs at the T6-T9 dermatome site 1 wk after vaccination with the COVID-19 vaccine (Oxford/ AstraZeneca ([ChAdOx1S{recombinant}]). The patient had a paraplegia aggravation 3 wk after HZ symptoms started. Spinal magnetic resonance imaging (MRI) showed transverse myelitis at the T6–T9 Level. Treatment was acyclovir with steroids combined with physical therapy. Her neurological function was slowly restored by Day 17.
CONCLUSION HZ developed after COVID-19 vaccination, which may lead to more severe complications. Therefore, HZ treatment itself should not be delayed. If neurological complications worsen after appropriate management, an immediate diagnostic procedure, such as magnetic resonance imaging and laboratory tests, will start and should treat the neurological complications.
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Affiliation(s)
- Su-Yeon Cho
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, South Korea
| | - Bo-Hyun Jang
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, South Korea
| | - Jun-Won Seo
- Department of Internal Medicine, Chosun University, College of Medicine, Gwangju 61453, South Korea
| | - Suk-Whee Kim
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, South Korea
| | - Kyung-Joon Lim
- Department of Anesthesiology and Pain Medicine, Chosun University, College of Medicine, Gwangju 61453, South Korea
| | - Hyun-Young Lee
- Department of Anesthesiology and Pain Medicine, Chosun University, College of Medicine, Gwangju 61453, South Korea
| | - Dong-Joon Kim
- Department of Anesthesiology and Pain Medicine, Chosun University, College of Medicine, Gwangju 61453, South Korea
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Herpes Simplex Virus and Varicella Zoster Virus Infections in Cancer Patients. Viruses 2023; 15:v15020439. [PMID: 36851652 PMCID: PMC9961783 DOI: 10.3390/v15020439] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/28/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Herpes simplex virus (HSV) and varicella zoster virus (VZV) are alpha herpesviruses that establish life-long latent infection in neuronal ganglia after primary infection. Periodic reactivation of these viruses results in recurrent infections that can have significant impact on patients' quality of life. HSV commonly causes oral and genital mucocutaneous infections whereas VZV is responsible for varicella/chickenpox and herpes zoster/shingles, but cancer patients are at particularly higher risk of complications including disseminated and visceral infections due to impaired cell-mediated immunity. While diagnosis of more common HSV and/or VZV infections is frequently clinically based, immunocompromised hosts may have atypical skin presentation or visceral involvement. Thus, diagnostic confirmation using virus-specific tests such as polymerase chain reaction or immunohistochemical staining is crucial in some cases. Oral acyclovir, valacyclovir and famciclovir are usually used for mild to moderate infections and intravenous acyclovir is the drug of choice for severe or disseminated infections. Foscarnet can be used when acyclovir-resistance is confirmed or suspected. Pharmaceutical prophylaxis against HSV and/or VZV should be considered in high-risk cancers patients. Currently, there is no commercially available vaccine against HSV, but VZV vaccines are available to prevent varicella and zoster.
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15
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Imai T, Fujita Y. Zoster sine herpete of the trigeminal nerve revisited as a COVID-19-associated disease: Atypical manifestation of herpes zoster masquerading odontogenic symptoms. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101265. [PMID: 35987500 PMCID: PMC9385378 DOI: 10.1016/j.jormas.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/28/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Tomoaki Imai
- Department of Oral and Maxillofacial Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan.
| | - Yusei Fujita
- Department of Oral and Maxillofacial Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
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16
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Gauthier Y, Lepreux S, Cario‐Andre M, Rambert J, Dakdaki A, Lafon M, Abouqal R, Benzekri L. Varicella-zoster virus in actively spreading segmental vitiligo skin: Pathological, immunochemical, and ultrastructural findings (a first and preliminary study). Pigment Cell Melanoma Res 2023; 36:78-85. [PMID: 36112095 PMCID: PMC10092484 DOI: 10.1111/pcmr.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 07/07/2022] [Accepted: 08/15/2022] [Indexed: 12/31/2022]
Abstract
Segmental vitiligo (SV) is a unilateral subtype of vitiligo which is clinically characterized by a cutaneous depigmentation and histologically by a melanocyte loss from the epidermis and hair follicle reservoirs. To date, its pathogenesis remains a mystery. In many cases, this skin depigmentation shares several clinical features and dysfunctions with herpes zoster (HZ). So, for the first time, we examined whether any nucleus and cell fusion associated with a positive immunolabelling of varicella-zoster virus (VZV) and VZV mature virions could be found in SV skin samples as in herpes zoster (HZ). A total of 40 SV samples were used for histological and immunochemical studies. Control samples were obtained from three HZ, and 10 generalized vitiligo lesions. For ultrastructural study, three recent SV and one HZ as controls were recruited. Here, we report that nuclear fusion in epidermal cells were statistically associated with recent SV (p < .001), whereas syncytia formation was associated with long-lasting SV (p = .001). A positive detection of VZV antigen was statistically associated in the epidermis with recent SV and in the dermis with long-lasting SV (p = .001). Finally, the discovery of mature virions in 3/3 recent SV samples provides additional arguments for our viral hypothesis.
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Affiliation(s)
- Yvon Gauthier
- Vitiligo and Melasma Research Association (V.M.R.A.)BordeauxFrance
| | | | - Muriel Cario‐Andre
- Bordeaux University, INSERM, BRIC, U1312BordeauxFrance
- National Reference Center for Rare skin DiseasesBordeaux University HospitalBordeauxFrance
- AquidermBordeauxFrance
| | - Jérome Rambert
- National Reference Center for Rare skin DiseasesBordeaux University HospitalBordeauxFrance
| | - Adrien Dakdaki
- Tumor Bank and Tumor Biology LaboratoryCHU BordeauxPessacFrance
| | - Marie‐Edith Lafon
- Department of Virology Bordeaux University HospitalBordeaux University, CNRS, UMR5234BordeauxFrance
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical Research and EpidemiologyMohammed V University in Rabat, Acute Medical Unit, Ibn Sina Teaching HospitalRabatMorocco
| | - Laila Benzekri
- Dermatology Department, Ibn Sina Teaching HospitalMohammed V University in Rabat, Pigmentary Disorders Outpatient ClinicRabatMorocco
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17
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Wilms L, Weßollek K, Peeters TB, Yazdi AS. Infektionen mit Herpes‐simplex‐ und Varizella‐zoster‐Virus. J Dtsch Dermatol Ges 2022; 20:1327-1353. [DOI: 10.1111/ddg.14917_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 08/18/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Larissa Wilms
- Klinik für Dermatologie und Venerologie Helios Klinikum Krefeld
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18
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Wilms L, Weßollek K, Peeters TB, Yazdi AS. Infections with Herpes simplex and Varicella zoster virus. J Dtsch Dermatol Ges 2022; 20:1327-1351. [DOI: 10.1111/ddg.14917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 08/18/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Larissa Wilms
- Department of Dermatology and Venereology Helios Klinikum Krefeld Germany
| | - Katharina Weßollek
- Department of Dermatology and Allergology University Hospital RWTH Aachen Germany
| | | | - Amir Sadegh Yazdi
- Department of Dermatology and Allergology University Hospital RWTH Aachen Germany
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19
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Ryu KJ, Kim DH. A Toxic Anterior Segment Syndrome-like Ocular Inflammatory Reaction after COVID-19 Vaccination. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.7.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: We report a case with bilateral, ocular inflammatory adverse reactions developing a few hours after COVID-19 vaccination.Case summary: A 70-year-old woman complained of headache and sudden visual impairment (both eyes) a few hours after COVID-19 vaccination (Astrazeneca). She had undergone bilateral cataract surgery 4 days before vaccination and her eyesight was good immediately after surgery. The best-corrected visual acuities (BCVA) were 0.2 and 0.1 in the right and left eyes, respectively. Diffuse corneal edema, anterior chamber reactions, inflammatory fibrinoid membranes on the anterior surfaces of the intraocular lenses (IOLs), and cystoid macular edema were observed in both eyes. The anterior chamber and IOL fibrinoid reactions much improved 7 days after the prescription of topical and oral corticosteroids. The aqueous humor polymerase chain reaction was positive for varicella zoster virus (VZV) in both eyes. The BCVA improved to 20/30 in the right eye and 20/50 in the left eye after 3 months of additional treatment. However, the cystoid macular edema did not improve.Conclusions: In patients with a history of herpes zoster infection, adverse ocular inflammatory reactions associated with VZV may occur immediately after COVID-19 vaccination.
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20
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Barsegian V, Kosova I. Zoster sine herpete causing voiding disorders in females. Scand J Urol 2022; 56:329-330. [DOI: 10.1080/21681805.2022.2096111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Vagan Barsegian
- Department of Urology and Surgical Andrology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Inga Kosova
- Department of Urology and Surgical Andrology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
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21
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Maltsev D, Fedirko V. Refractory atypical trigeminal neuralgia associated with reactivated herpesvirus infection: pathogenetic link and efficacy of combination antiviral therapy. Virusdisease 2022; 33:155-165. [DOI: 10.1007/s13337-022-00769-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/27/2022] [Indexed: 11/28/2022] Open
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22
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Fader F, Gendeh HS, Goh BS. Where are the vesicles? A case report of Ramsay Hunt syndrome. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2022; 17:90-93. [PMID: 35440954 PMCID: PMC9004438 DOI: 10.51866/cr1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 1-year-10-month-old child developed left-sided Ramsay Hunt syndrome (RHS) without vesicles 1 month after an episode of varicella zoster infection. No ear symptoms, including hearing loss, tinnitus, or imbalance, were reported. The external ear and otoscopic examinations were unremarkable. He achieved adequate recovery with corticosteroid treatment. This case report discusses the unusual presentation of RHS without vesicles, the diagnostic dilemma in young children, varicella zoster virus hepatitis, treatment modalities, and the role of vaccination in its prevention.
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Affiliation(s)
- Farhan Fader
- MB ChB, Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Canselor Tuanku Muhriz UKM, Cheras, Kuala Lumpur, Malaysia,
| | - Hardip Singh Gendeh
- BmedSci; BMBS, Dr. ORL-HNS, Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Canselor Tuanku Muhriz UKM, Cheras, Kuala Lumpur, Malaysia
| | - Bee See Goh
- M.D (UKM), M.S (ORL-HNS), Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Canselor Tuanku Muhriz UKM, Cheras, Kuala Lumpur, Malaysia
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23
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Hong SW, Kim MJ, Park CH, Park S, Kim JH. Dorsal root ganglion stimulation combined with spinal cord stimulation for effective treatment of postherpetic neuralgia - A case report. Anesth Pain Med (Seoul) 2022; 16:387-390. [PMID: 35139621 PMCID: PMC8828630 DOI: 10.17085/apm.21032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background Although spinal cord stimulation (SCS) can be a treatment option for intractable postherpetic neuralgia (PHN), obtaining proper stimulation at the thoracic dermatome is difficult. Dorsal root ganglion (DRG) stimulation may be an effective treatment for patients with insufficient efficacy in SCS only. Case A 54-year-old male with intractable PHN was referred to our clinic. Pain was localized to the distribution of the T1–3 dermatomes. SCS trial was conducted, and lead was placed within the epidural space over the C6–T1 level; however, the stimulation was inadequate for his pain site. Therefore, another lead was placed within the left T1 and T2 DRG for trial, and T1 DRG stimulation provided adequate stimulation. T1 DRG stimulation and SCS could cover the entire pain site with paresthesia, and his pain was decreased by over 50%. Conclusions DRG stimulation combined with SCS may be a good treatment option for intractable thoracic PHN.
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Affiliation(s)
- Seung Wan Hong
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Min Jung Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Cheol Hwan Park
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Sarah Park
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jae Hun Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
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24
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Kombe Kombe AJ, Xie J, Zahid A, Ma H, Xu G, Deng Y, Nsole Biteghe FA, Mohammed A, Dan Z, Yang Y, Feng C, Zeng W, Chang R, Zhu K, Zhang S, Jin T. Detection of Circulating VZV-Glycoprotein E-Specific Antibodies by Chemiluminescent Immunoassay (CLIA) for Varicella-Zoster Diagnosis. Pathogens 2022; 11:pathogens11010066. [PMID: 35056014 PMCID: PMC8778750 DOI: 10.3390/pathogens11010066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 02/01/2023] Open
Abstract
Varicella and herpes zoster are mild symptoms-associated diseases caused by varicella–zoster virus (VZV). They often cause severe complications (disseminated zoster), leading to death when diagnoses and treatment are delayed. However, most commercial VZV diagnostic tests have low sensitivity, and the most sensitive tests are unevenly available worldwide. Here, we developed and validated a highly sensitive VZV diagnostic kit based on the chemiluminescent immunoassay (CLIA) approach. VZV-glycoprotein E (gE) was used to develop a CLIA diagnostic approach for detecting VZV-specific IgA, IgG, and IgM. The kit was tested with 62 blood samples from 29 VZV-patients classified by standard ELISA into true-positive and equivocal groups and 453 blood samples from VZV-negative individuals. The diagnostic accuracy of the CLIA kit was evaluated by receiver-operating characteristic (ROC) analysis. The relationships of immunoglobulin-isotype levels between the two groups and with patient age ranges were analyzed. Overall, the developed CLIA-based diagnostic kit demonstrated the detection of VZV-specific immunoglobulin titers depending on sample dilution. From the ELISA-based true-positive patient samples, the diagnostic approach showed sensitivities of 95.2%, 95.2%, and 97.6% and specificities of 98.0%, 100%, and 98.9% for the detection of VZV-gE-specific IgA, IgG, and IgM, respectively. Combining IgM to IgG and IgA detection improved diagnostic accuracy. Comparative analyses on diagnosing patients with equivocal results displaying very low immunoglobulin titers revealed that the CLIA-based diagnostic approach is overall more sensitive than ELISA. In the presence of typical VZV symptoms, CLIA-based detection of high titer of IgM and low titer of IgA/IgG suggested the equivocal patients experienced primary VZV infection. Furthermore, while no difference in IgA/IgG level was found regarding patient age, IgM level was significantly higher in young adults. The CLIA approach-based detection kit for diagnosing VZV-gE-specific IgA, IgG, and IgM is simple, suitable for high-throughput routine analysis situations, and provides enhanced specificity compared to ELISA.
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Affiliation(s)
- Arnaud John Kombe Kombe
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Jiajia Xie
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Ayesha Zahid
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Huan Ma
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Guangtao Xu
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Yiyu Deng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Fleury Augustin Nsole Biteghe
- Gabonese Scientific Research Consortium, Libreville, Gabon;
- Department of Radiation Oncology, Cedars Sinai Hospital, Los Angeles, CA 90048, USA
| | - Ahmed Mohammed
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Zhao Dan
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Yunru Yang
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Chen Feng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Weihong Zeng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Ruixue Chang
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Keyuan Zhu
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Siping Zhang
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
- Correspondence: (S.Z.); (T.J.); Tel.: +86-0551-62283151 (S.Z.); +86-551-63600720 (T.J.)
| | - Tengchuan Jin
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
- CAS Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China
- Correspondence: (S.Z.); (T.J.); Tel.: +86-0551-62283151 (S.Z.); +86-551-63600720 (T.J.)
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25
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Tanizaki R, Miyamatsu Y. Zoster sine herpete following BNT162b2 mRNA COVID-19 vaccination in an immunocompetent patient. IDCases 2022; 29:e01563. [PMID: 35855938 PMCID: PMC9276537 DOI: 10.1016/j.idcr.2022.e01563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 10/30/2022] Open
Abstract
As a result of the COVID-19 pandemic, mRNA vaccination has become widespread. Recently, it has been suggested that instances of herpes zoster increase following mRNA COVID-19 vaccination. Herein, we describe the first case of zoster sine herpete (ZSH) after mRNA vaccination for COVID-19. A 60-year-old Japanese immunocompetent man presented with fever, fatigue, headache, cervical pain, and lumbar pain, which developed after receiving a second dose of BNT162b2 mRNA COVID-19 vaccination. Whereas most symptoms improved with symptomatic treatment, headache and numbness of the right forehead persisted in areas innervated by the trigeminal and second and third cervical nerves. Based on positive results of an enzyme-linked immunosorbent assay examination for anti-VZV IgM, ZSH was diagnosed, and amitriptyline improved the patient’s symptoms. Diagnosis of ZSH is challenging due to the lack of a characteristic herpes zoster rash. Physicians should be aware that ZSH can develop after mRNA vaccination.
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26
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Kim YS, Son JS, Lee H, Doo AR. A case report of refractory otalgia after Ramsay Hunt syndrome successfully treated by applying pulsed radiofrequency to the great auricular nerve: A CARE-compliant article. Medicine (Baltimore) 2021; 100:e27285. [PMID: 34596124 PMCID: PMC8483850 DOI: 10.1097/md.0000000000027285] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/02/2021] [Indexed: 02/07/2023] Open
Abstract
RATIONALE Ramsay Hunt syndrome is a type of herpes zoster infection involving geniculate ganglion and facial nerve. Unilateral facial palsy, otalgia, and painful vesicular rash on the auricle and external auditory canal are the typical symptoms. Although postherpetic neuralgia (PHN) is a devastating complication of herpes zoster infection, PHN following Ramsay Hunt syndrome has rarely been reported. PATIENT CONCERNS A 55-year-old immunocompetent female patient visited our pain clinic, for left-sided refractory otalgia (PHN) that persisted for 3 months after she was diagnosed with Ramsay Hunt syndrome. Although facial palsy and tinnitus had recovered within 2 to 4 weeks after symptom onset, the patient had been experiencing a persistent and severe otalgia radiating to mandibular angle, temporal and upper cervical area of neuropathic nature. DIAGNOSES The patient's pain persisted despite conservative medication and administration of ultrasound-guided stellate ganglion block, facial nerve block, and great auricular nerve block several times. INTERVENTIONS The patient was treated with the application of ultrasound-guided pulsed radiofrequency (PRF) to the great auricular nerve. OUTCOMES The patient experienced significant pain reduction more than 50% on a numeric rating scale after 2 weeks of PRF treatment. LESSONS Chronic otalgia might be a type of PHN after Ramsay Hunt syndrome with cervical nerve involvement. PRF treatment to the great auricular nerve can be a therapeutic option for refractory otalgia following Ramsay Hunt syndrome.
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Affiliation(s)
- Ye Sull Kim
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital and Medical School, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Ji-Seon Son
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital and Medical School, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Hyungseok Lee
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital and Medical School, Jeonju, South Korea
| | - A. Ram Doo
- Department of Anesthesiology and Pain Medicine, Jeonbuk National University Hospital and Medical School, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
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27
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Yun G, Kim E, Baik J, Do W, Jung YH, You CM. Diagnosis and management of ophthalmic zoster sine herpete accompanied by cervical spine disc protrusion: A case report. World J Clin Cases 2021; 9:7588-7592. [PMID: 34616830 PMCID: PMC8464478 DOI: 10.12998/wjcc.v9.i25.7588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/14/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Zoster sine herpete (ZSH) can be misdiagnosed because there are no typical vesicular eruptions characterized by a dermatomal distribution. However, incorrect treatment due to a misdiagnosis can lead to severe pain and fatal complications.
CASE SUMMARY A 75-year-old woman complained of sudden onset right shoulder pain and atypical headache. After 18 d, sudden hearing loss occurred in the left ear. In serology tests conducted after the onset of hearing loss, varicella-zoster virus IgM was positive. She had no history of a rash or trauma. Under the suspicion of ZSH, antiviral treatment and stellate ganglion block were administered four times, and the pain was effectively controlled.
CONCLUSION Early diagnosis and treatment of ZSH can help not only by reducing pain but also by preventing fatal complications.
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Affiliation(s)
- Giyoung Yun
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
- Department of Anesthesia and Pain Medicine, Pusan National University, School of Medicine, Yangsan 50612, South Korea
| | - Eunsoo Kim
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
- Department of Anesthesia and Pain Medicine, Pusan National University, School of Medicine, Yangsan 50612, South Korea
| | - Jiseok Baik
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Wangseok Do
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Young-Hoon Jung
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Chang-Min You
- Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
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Sahra S, Jahangir A, Gavica MC, Mobarakai N, Jahangir A. First case report of pulmonary embolism with Zoster Sine Herpete. Respir Med Case Rep 2021; 33:101462. [PMID: 34401298 PMCID: PMC8349081 DOI: 10.1016/j.rmcr.2021.101462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 11/02/2022] Open
Abstract
Background Varicella-Zoster Virus (VZV) infection is known to cause coagulation abnormalities leading to pulmonary embolism and ischemic strokes. The incidence of vascular and thrombotic complications with Zoster Sine Herpete has been reported very infrequently in the medical literature. Case presentation A 32-year-old man with no significant past medical history presented to Emergency Room with right-sided facial weakness and headache. We saw no rash on physical examination. A sub-segmental pulmonary embolus was found on C.T. angiography of the chest. VZV was detected on Lumbar Puncture studies. The patient responded well to anti-viral treatment and was discharged home without any complications. Conclusion The suspicion of thrombo-embolic complications should be high with Zoster Sine Herpete. Screening for coagulopathies and timely initiation of anticoagulation should be carried out in appropriate clinical settings.
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Affiliation(s)
- Syeda Sahra
- Staten Island University Hospital, Staten Island, NY, 10305, USA
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29
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Luís MEV, Hipólito-Fernandes CD, Lopes Moniz J, Ferreira JT. The Neurotropic Varicella Zoster Virus: a Case of Isolated Abducens Nerve Palsy without Skin Rash in a Young Healthy Woman. Strabismus 2021; 29:168-173. [PMID: 34241572 DOI: 10.1080/09273972.2021.1948073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Varicella Zoster Virus (VZV) is a neurotropic virus whose reactivation can affect the central nervous system (CNS) and manifest as different neurological syndromes usually with dermatological involvement. Extraocular muscle palsies are not commonly described associated with VZV and their presence in the absence of a typical zoster rash is even rarer. METHODS Case report of a young immunocompetent patient with unilateral abducens nerve palsy, as an isolated manifestation of VZV infection. RESULTS A 25-year-old healthy female presented to the emergency department with a subacute onset of painless horizontal binocular diploplia, over a month. Ophthalmological and neurological examination revealed an isolated right abducens nerve palsy, and polymerase chain reaction of the cerebrospinal fluid identified a VZV infection. There was no skin rash involvement. Other infectious, inflammatory, and autoimmune diseases were excluded. Treatment with intravenous acyclovir and dexamethasone improved but not completely resolved the diplopia and strabismus. The patient was submitted to a medial rectus recession surgery. DISCUSSION VZV manifestations in the CNS can occur in healthy young individuals and can manifest in the absence of the typical skin rash. Isolated sixth nerve palsy is a very rare manifestation of VZV infection. Young patients with isolated ocular motor mononeuropathies, even with cardiovascular risk factors, benefit from a CNS-based approach and MRI and lumbar puncture should be considered. Reports show that extraocular muscle palsy associated with VZV is a transient condition and resolve partially or completely after few weeks.
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Affiliation(s)
| | | | | | - Joana Tavares Ferreira
- Ophthalmology Department, Hospital CUF Descobertas, Lisbon.,Neuro-Ophthalmology Department; Centro Hospitalar Universitário De Lisboa Norte, Lisbon
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30
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Al-Ani HH, Niederer RL. Zoster sine herpete: a disease that ophthalmologists should be aware of. Korean J Pain 2020; 33:403-404. [PMID: 32989207 PMCID: PMC7532302 DOI: 10.3344/kjp.2020.33.4.403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 12/03/2022] Open
Affiliation(s)
- Haya H Al-Ani
- Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Rachael L Niederer
- Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
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