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      Sacral (S1) herpes zoster

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          Herpes zoster usually affects the thoracic and lumbar vertebra (T3–L3), while sacral herpes zoster has been very rarely reported. We present a very rare case of herpes zoster involving S1 dermatome in a 35-year-old healthy man who presented aching pain and typical herpes zoster eruption on the lateral aspect of the calcaneus, lateral plantar area and dorsal aspect of digits III and IV.

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          Most cited references 9

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          Influence of frequent infectious exposures on general and varicella-zoster virus-specific immune responses in pediatricians.

          Reexposure to viruses is assumed to strengthen humoral and cellular immunity via the secondary immune response. We studied the effects of frequent exposure to viral infectious challenges on immunity. Furthermore, we assessed whether repetitive exposures to varicella-zoster virus (VZV) elicited persistently high immune responses. Blood samples from 11 pediatricians and matched controls were assessed at 3 time points and 1 time point, respectively. Besides the assessment of general immunity by means of measuring T-cell subset percentages, antibody titers and gamma interferon (IFN-γ)/interleukin 2 (IL-2)-producing T-cell percentages against adenovirus type 5 (AdV-5), cytomegalovirus (CMV), tetanus toxin (TT), and VZV were determined. Pediatricians had lower levels of circulating CD4(+)-naive T cells and showed boosting of CD8(+) effector memory T cells. Although no effect on humoral immunity was seen, repetitive exposures to VZV induced persistently higher percentages of IFN-γ-positive T cells against all VZV antigens tested (VZV glycoprotein E [gE], VZV intermediate-early protein 62 [IE62], and VZV IE63) than in controls. T cells directed against latency-associated VZV IE63 benefitted the most from natural exogenous boosting. Although no differences in cellular or humoral immunity were found between the pediatricians and controls for AdV-5 or TT, we did find larger immune responses against CMV antigens in pediatricians. Despite the high infectious burden, we detected a robust and diverse immune system in pediatricians. Repetitive exposures to VZV have been shown to induce a stable increased level of VZV-specific cellular but not humoral immunity. Based on our observations, VZV IE63 can be considered a candidate for a zoster vaccine.
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            Urological manifestations of herpes zoster.

             J Osca,  J. Morera,  E Broseta (1992)
            Herpes zoster is an infection caused by the varicella virus. Inflammatory reaction can involve the spinal cord and anterior horn cells causing varied neurological disorders including urological alterations. We reviewed 57 patients who suffered herpes zoster between 1984 and 1991. 15 of them (26%) showed urological manifestations: 2 cases acute urinary retention, 3 patients urinary incontinence and 10 cases had a cystitis-like syndrome. The clinical findings and diagnostic procedures are studied. The possible etiological mechanisms are discussed. The literature is reviewed.
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              Rectal ulcer in a patient with VZV sacral meningoradiculitis (Elsberg syndrome)


                Author and article information

                J Pain Res
                J Pain Res
                Journal of Pain Research
                10 May 2019
                : 12
                : 1475-1477
                [1 ]The Department of Dermato-Physiology, Apollonia University , Iaşi, Romania
                [2 ]Department of Dermatology, Nicolina Medical Center , Iaşi, Romania
                [3 ]“P. Poni’’ Institute of Macromolecular Chemistry , Iaşi, Romania
                [4 ]Department of Epidemiology, University of Medicine and Pharmacy " Grigore T Popa" , Iaşi, Romania
                [5 ]The Department of Foreign Languages, The University of Medicine and Pharmacy of Tîrgu Mureș , Tîrgu Mureș, , Romania
                [6 ]The Department of Applied Simulation in Medicine, The University of Medicine and Pharmacy of Tîrgu Mureș , Tîrgu Mureș, Romania
                [7 ]The Department of Cardiology, The University of Medicine and Pharmacy of Tîrgu Mureș , Tîrgu Mureș, Romania
                [8 ]The Department of Pathology, The University of Medicine and Pharmacy of Tîrgu Mureș , Tîrgu Mureș, Romania
                Author notes
                Correspondence: Adrian NazneanThe Department of Foreign Languages, The University of Medicine and Pharmacy of Tîrgu Mureș , 38 Gheorghe Marinescu Street, Tîrgu Mureș, 540139, RomaniaTel +40 2652 1551Email adinaznean@ 123456yahoo.com
                © 2019 Chiriac et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 2, References: 11, Pages: 3
                Case Report

                Anesthesiology & Pain management

                herpes zoster, s1, pain, sacral zoster


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