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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

      52,235 Monthly downloads/views I 2.832 Impact Factor I 4.5 CiteScore I 1.2 Source Normalized Impact per Paper (SNIP) I 0.655 Scimago Journal & Country Rank (SJR)

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      Sacral (S1) herpes zoster

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          Abstract

          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.

          Most cited references9

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          Asymptomatic reactivation and shed of infectious varicella zoster virus in astronauts.

          Randall Cohrs, Satish Mehta, D. Scott Schmid … (2008)
          Varicella zoster virus (VZV) causes varicella (chickenpox), after which virus becomes latent in ganglia along the entire neuraxis. Virus reactivation produces zoster (shingles). Infectious VZV is found in vesicles of patients with zoster and varicella, but virus shed in the absence of disease has not been documented. VZV DNA was previously detected in saliva of astronauts during and after spaceflight, a uniquely stressful environment in which cell mediated immunity (CMI) is temporally dampened. The decline in CMI to VZV associated with zoster led to the hypothesis that infectious VZV would also be present in the saliva of astronauts subjected to stress of spaceflight. Herein, not only was the detection of salivary VZV DNA associated with spaceflight validated, but also infectious virus was detected in saliva from 2 of 3 astronauts. This is the first demonstration of shed of infectious VZV in the absence of disease.
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            Influence of frequent infectious exposures on general and varicella-zoster virus-specific immune responses in pediatricians.

            Hilde Jansens, Pierre Damme, Philippe Beutels … (2014)
            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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              Sacral Herpes Zoster Associated with Voiding Dysfunction in a Young Patient with Scrub Typhus

              Jian Hur (2015)
              When a patient presents with acute voiding dysfunction without a typical skin rash, it may be difficult to make a diagnosis of herpes zoster. Here, we present a case of scrub typhus in a 25-year-old man with the complication of urinary dysfunction. The patient complained of loss of urinary voiding sensation and constipation. After eight days, he had typical herpes zoster eruptions on the sacral dermatomes and hypalgesia of the S1-S5 dermatomes. No cases of dual infection with varicella zoster virus and Orientia tsutsugamushi were found in the literature. In the described case, scrub typhus probably induced sufficient stress to reactivate the varicella zoster virus. Early recognition of this problem is imperative for prompt and appropriate management, as misdiagnosis can lead to long-term urinary dysfunction. It is important that a diagnosis of herpes zoster be considered, especially in patients with sudden onset urinary retention.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Pain Res
                Journal ID (iso-abbrev): J Pain Res
                Journal ID (publisher-id): JPR
                Journal ID (pmc): jpainres
                Title: Journal of Pain Research
                Publisher: Dove
                ISSN (Electronic): 1178-7090
                Publication date (Electronic): 10 May 2019
                Publication date Collection: 2019
                Volume: 12
                Pages: 1475-1477
                Affiliations
                [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
                Article
                Publisher ID: 199124
                DOI: 10.2147/JPR.S199124
                PMC ID: 6519706
                PubMed ID: 31190957
                SO-VID: 62ad52f6-e0ce-4951-8fec-335ee25b9c90
                Copyright © © 2019 Chiriac et al.
                License:

                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).

                History
                Date received : 21 December 2018
                Date accepted : 10 April 2019
                Page count
                Figures: 2, References: 11, Pages: 3
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: herpes zoster,s1,pain,sacral zoster
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: herpes zoster, s1, pain, sacral zoster

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