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      Bilateral herpes zoster in a patient with end-stage kidney disease

      case-report

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          Abstract

          Herpes zoster (HZ) is caused by the reactivation of a latent varicella-zoster virus (VZV) infection within the cranial or dorsal root ganglia. The cutaneous lesions of HZ are typically limited to a single dermatome, while non-contiguous HZ involving two or more dermatomes is a very rare clinical entity. In this report, we describe a case of HZ involving the left and right side of the abdomen corresponding to the T11 dermatome in a 63-year-old man on chronic peritoneal dialysis. The characteristic cutaneous manifestation encouraged us to ascribe the disease to HZ duplex bilateralis, and the patient was given a single dose of oral valacyclovir and achieved a favorable outcome. The therapeutic concerns regarding the reactivation of VZV in patients with end-stage kidney disease are also discussed.

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          Varicella-zoster virus: atypical presentations and unusual complications.

          John W Gnann (2002)
          Varicella-zoster virus (VZV) is the etiologic agent of varicella (primary infection) and herpes zoster (reactivation of latent infection). Although varicella is most often a relatively benign and self-limited childhood illness, the disease can be associated with a variety of serious and potentially lethal complications in both immunocompetent and immunocompromised persons. One complication of varicella that appears to be increasing in frequency is serious bacterial soft tissue infections caused by group A streptococci. Issues related to management of varicella become especially complex when varicella involves pregnant women or susceptible neonates. Herpes zoster can be associated with a variety of neurologic complications, including a syndrome of delayed contralateral hemiparesis. Neurologic complications of herpes zoster, including chronic encephalitis, occur with increased frequency in AIDS patients. VZV retinitis is a potentially sight-threatening complication that occurs in both immunocompetent and immunocompromised persons. Current knowledge regarding pathogenesis and antiviral therapy is reviewed.
          Article 0 comments Cited 71 times – based on 0 reviews     Review now
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            Risk of Herpes zoster in patients with underlying diseases: a retrospective hospital-based cohort study

            A Hata, M. Kuniyoshi, Y. Ohkusa (2011)
            Purpose To determine the incidence of Herpes zoster in patients with one of 17 specific underlying diseases compared with that in patients with other underlying diseases. Methods We conducted a retrospective hospital-based cohort study using data from patients’ electronic medical records for the period 2001–2007 of the Kitano Hospital Research Database. These analyses included 55,492 patients with one of 17 underlying diseases, which were those reported as related to the contraction of Herpes zoster. Of these, 769 patients contracted Herpes zoster. The main outcome measure was the clinical diagnosis of Herpes zoster. Results The adjusted hazard ratios (95% confidence interval) for Herpes zoster in patients with the 17 diseases were compared with other patients, with the following results: brain tumor [3.84 (2.51–5.88)], lung cancer [2.28 (1.61–3.22)], breast cancer [2.41 (1.52–3.82)], esophageal cancer [4.19 (2.16–8.11)], gastric cancer [1.95 (1.39–2.72)], colorectal cancer [1.85 (1.33–2.56)], gynecologic cancer [3.45 (2.08–5.70)], malignant lymphoma [8.23 (6.53–10.38)], systemic lupus erythematosus [3.90 (2.66–5.70)], rheumatoid arthritis [2.00 (1.60–2.50)], diabetes mellitus [2.44 (2.10–2.85)], hypertension [2.04 (1.75–2.38)], renal failure [2.14 (1.65–2.79)], and disk hernia [2.18 (1.52–3.13)]. Conclusions Patients with diabetes mellitus, renal failure, and malignancies have a 1.8–8.4-fold higher risk of a Herpes zoster event than patients with other diseases. Future studies should investigate alteration of the immune system in the underlying diseases and approaches for Herpes zoster prevention.
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              Herpes zoster: epidemiology, natural history, and common complications.

              Jeffrey M Weinberg (2007)
              Herpes zoster is a disease associated with aging that can significantly impair quality of life for affected individuals. Anyone infected with varicella (chickenpox) virus in childhood is at risk for reactivation of dormant virus and the onset of zoster disease, although it occurs with increasing frequency in the elderly as a result of waning of cell-mediated immunity. The most common complication of herpes zoster is postherpetic neuralgia, which can cause chronic and debilitating pain. Current treatments can decrease the severity of zoster rash and pain but cannot prevent disease onset or completely eliminate the most frequent symptoms. The zoster vaccine may help prevent the onset of herpes zoster in the target population of those age 60 years and older. This summary reviews the epidemiology, pathogenesis, natural history, and common symptoms of zoster disease.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int Med Case Rep J
                Journal ID (iso-abbrev): Int Med Case Rep J
                Journal ID (publisher-id): International Medical Case Reports Journal
                Title: International Medical Case Reports Journal
                Publisher: Dove Medical Press
                ISSN (Electronic): 1179-142X
                Publication date Collection: 2017
                Publication date (Electronic): 19 June 2017
                Volume: 10
                Pages: 209-212
                Affiliations
                Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan
                Author notes
                Correspondence: Tetsu Akimoto, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi 329-0498, Japan, Tel +81 28 558 7346, Fax +81 28 544 4869, Email tetsu-a@ 123456jichi.ac.jp
                Article
                Publisher ID: imcrj-10-209
                DOI: 10.2147/IMCRJ.S138398
                PMC ID: 5484569
                SO-VID: 8120627a-a829-4453-8657-54e8f3d92a43
                Copyright © © 2017 Akimoto et al. This work is published and licensed by Dove Medical Press Limited
                License:

                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.

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                Categories
                Subject: Case Report

                Keywords: herpes zoster duplex bilateralis,end-stage kidney disease,peritoneal dialysis,valacyclovir,dermatome
                Data availability:
                Keywords: herpes zoster duplex bilateralis, end-stage kidney disease, peritoneal dialysis, valacyclovir, dermatome

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