Reactivation of varicella-zoster virus (VZV) that has remained dormant within dorsal root ganglia, often for decades after the patient s initial exposure to the virus in the form of varicella (chickenpox), results in herpes zoster (shingles). Pain may simulate headache, iritis, pleurisy, brachial neuritis, cardiac pain, appendicitis or other intra-abdominal disease, or sciatica. PHN is observed more frequently after cases of herpes zoster ophthalmicus (HZO) and in instances of upper-body dermatomal involvement. VZV infection is an acute neurologic disease that warrants immediate evaluation. Herpes Zoster (1). Description Herpes zoster ophthalmicus is a dermalogical and neurologic disorder caused by the varicella-zoster virus. Reactivation of varicella zoster virus (VZV) from latently infected human ganglia usually produces herpes zoster (shingles), characterized by dermatomal distribution pain and rash. VZV DNA, but not HSV DNA, was found in the CSF of the first patient 5 months after the onset of pain, and in the second patient, 8 months after pain onset (Gilden et al. A second case of acute cerebellitis caused by VZV in the absence of rash occurred in a middle-aged, immunocompetent woman; virological analysis of her CSF revealed VZV DNA and anti-VZV IgG antibody (Moses et al.
Primary infection causes varicella (chickenpox), after which virus becomes latent in ganglionic neurons along the entire neuraxis. Diagnosis of VZV-induced neurological disease may require examination of CSF, serum and/ or ocular fluids. In conjunction with dermatological manifestations of VZV reactivation, VZV can reactivate from one or more cranial nerve ganglia to cause disease. Herpes zoster ophthalmicus (HZO) is often accompanied by keratitis, which can lead to blindness. After this the virus lies dormant in the sensory nervous system in the geniculate, trigeminal or dorsal root ganglia. Shingles is seen as a disease of older people but it can affect all ages, including children. Persons at highest risk for complications are elderly persons, those with herpes zoster ophthalmicus, and immunocompromised patients.
Recent data suggest that varicella zoster virus (VZV)-associated complications of the central nervous system (CNS) are more common and diverse than previously thought. The main purpose of this article is to describe the clinical characteristics and the outcome of patients suffering from meningitis and encephalitis caused by VZV reactivation. Patients with neurological symptoms, detectable VZV DNA in the CSF, and available clinical records were included in the study. Congenital Varicella Syndrome is an extremely rare disorder in which affected infants have distinctive abnormalities at birth (congenital) due to the mother’s infection with chickenpox (maternal varicella zoster) early during pregnancy (i. It can occur in the absence of skin disease but is more frequently caused by a dermatological problem. Identification and prompt treatment of early herpes zoster with oral antiviral agents prevents postherpetic neuralgia or reduces its severity.
Varicella Zoster Complications
If indeed the cause of herpes zoster is infectious viral particles that spread from the ganglion into the periphery, one might expect a similar spread orthodromically from the ganglion into the spinal cord in cases of spinal herpes zoster and into the brain stem in cranial herpes zoster. Patients who presented more than 1 week after initiation of zoster symptoms and patients with a history of a previous neurological disorder were excluded from the study. (2000) Neurologic complications of the reactivation of varicella-zoster virus. Corneal Complications From Herpes Zoster Ophthalmicus. Corneal mucous plaque, exposure keratitis, herpes zoster ophthalmicus,. In HZO are clinically indistinguishable from those caused by HSV infection. Many conditions, such as neurotrophic keratitis after HSV infection or LASIK, include. Surface disease (e.g., HSV, varicella zoster virus, ocular mucous membrane. Case Reports in Dermatological Medicine is a peer-reviewed, open access journal that publishes case reports in all areas of dermatological medicine. Neurological examination was unremarkable, apart from a subjective sensation of numbness of the glans penis. Varicella zoster virus (VZV) is associated with two distinct disease entities: chicken pox, which is primarily seen in children, and herpes zoster (shingles), which occurs predominantly in an older age group 1. Herpes zoster (HZ) is caused by the reactivation of the VZV, which remains dormant in the geniculate and Gasserian and dorsal root ganglia following a primary chicken pox infection. Shingles is a disease caused by the same virus that causes chickenpox, the varicella zoster virus. Shingles is also called herpes zoster and affects nerve cells and the skin with nerve pain and a skin rash. Dermatological Immunology / Diagnostic Laboratory (Skin Allergies). Shingles is caused by reactivation of the Varicella zoster virus (VZV). Other dermatological conditions that may be considered include: herpes simplex, impetigo, atopic eczema or contact dermatitis. Herpes zoster ophthalmicus occurs when shingles affects the ophthalmic branch of the trigeminal nerve (the 5th cranial nerve). Neurologic complications of the reactivation of varicellazoster virus. The Lancet Neurology. Herpes simplex viruses types 1 and 2 (HSV1 and HSV2) and varicella-zoster virus (VZV) establish latent infection in dorsal root ganglia for the entire life of the host. Although the viruses vary in the clinical disorders they cause and in their molecular structure, they share several features that affect the course of infection of the human nervous system. The dermatological appearance of herpes zoster is, in most cases, sufficiently distinctive for accurate diagnosis.
Infection Of The Central Nervous System Caused By Varicella Zoster Virus Reactivation: A Retrospective Case Series Study
Chickenpox is caused by the varicella-zoster virus (VZV), also known as human herpes virus 3 (HHV-3), one of the eight herpes viruses known to affect humans. Serious complications of shingles include post-herpetic neuralgia, zoster multiplex, myelitis, herpes ophthalmicus, or zoster sine herpete. Other neurological disorder: Damage to cervical and lumbosacral spinal cord, motor/sensory deficits, absent deep tendon reflexes, anisocoria/Horner’s syndrome. ISBN 1414403682; New Zealand Dermatological Society (NZDS). Neurological disorders related to AIDs are reviewed elsewhere.4 5 Syphilis, discussed below, is another important neurocutaneous complication of AIDS. Dermatological findings are particularly helpful in diagnosing aseptic meningitides or those associated with indolent organisms. The varicella zoster virus causes two distinct syndromes: a primary infection (chickenpox) and a recurrent infection (shingles) after reactivation of virus that has lain dormant in the dorsal root ganglia for years after the primary infection. Reactivation of the virus in the ophthalmic branch of the trigeminal nerve results in herpes zoster ophthalmicus. Ramsay Hunt syndrome is caused by reactivation of varicella zoster virus (VZV) involving the facial nerve; facial paralysis, ear pain and vesicles in the ear are diagnostic. It is an acute neurological disease which can often lead to serious postherpetic neuralgia (PHN). The dermatological rash and pain associated with HZ typically resolves within one month of presentation 2.
Extractions: Shingles is a localized infection due to the varicella-zoster virus, the same virus that causes chickenpox. Herpes zoster ophthalmicus a surgical operation Shingles patients are infectious (resulting in chickenpox), both from virus in the lesions and in some instances the nose and throat. (shingles, often complicated by serious neurological and ocular disorders.