Case ReportsVisceral zoster as the presenting feature of disseminated herpes zoster☆,☆☆,★
Section snippets
Case report
A 77-year-old man was first seen in the emergency department with a 6-day history of progressively worsening, constant, dull, nonpleuritic, right-sided, localized thoracic wall pain radiating to the right side of the back. The pain was associated with anorexia, insomnia, and emesis. This was the third time in 3 days that he had sought medical treatment for the pain, having previously been given a diagnosis of nonspecific musculoskeletal pain, supported by unremarkable findings of laboratory and
Discussion
After initial infection with primary VZV, the virus spreads from the epidermis to sensory nerve endings, then centripetally to the dorsal root ganglion where it enters a latent stage.4 There are conflicting reports in the literature regarding reinfection as a significant cause of herpes zoster in patients with cancer, but the best evidence suggests that reactivation is most likely.1, 2, 3, 5, 6, 11, 12 The mechanisms of reactivation are poorly understood, but aging, trauma, stress, radiation,
Acknowledgements
I thank Al Martin, MD, Don Schreiber, MD, Terri Perrone, MD, David Grekin, MD, John Melski, MD, Laura Bliven, HT, and the Marshfield Clinic medical library staff for their help in the completion of this manuscript.
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Non-dermatomal cutaneous herpes zoster infection in a solid-organ transplant patient
2022, IDCasesCitation Excerpt :Visceral involvement in high-risk patients increases the morbidity and mortality associated with VZV requiring prompt diagnosis and treatment of cutaneous VZV infection to reduce the risk of dissemination. In the setting of immunocompromise, HZ can present as classic zoster (localized rash), dermatomal zoster with dissemination, atypical generalized zoster with or without visceral involvement, and visceral zoster without skin lesions [3,4,7,9]. Disseminated cutaneous HZ is defined as having more than 20 vesicles outside the primary and immediately adjacent dermatomes or affecting three or more dermatomes [3].
Infectious causes of acute pancreatitis: A systematic review
2020, PancreatologyCitation Excerpt :A total of 212 articles were included for review. Two publications were case control studies [8,9], 23 publications were case series [10–32]and 187 were case reports [6,33–74] [75-105] [106-135] [136-165] [166-195] [196-215]. The year of publication ranged from 1965 to 2019.
An Analysis of Epidemiology, Etiology, and Outcomes of Acute Pancreatitis in Renal Transplant Recipients
2020, Transplantation ProceedingsA case of Disseminated Herpes Zoster in a patient with Multiple Sclerosis on Glatiramer acetate
2020, IDCasesCitation Excerpt :Disseminated herpes zoster when more than 2 contiguous dermatomes are affected, more than 20 vesicles are observed outside the initial dermatome, or involvement is systemic. DHZ is rare and most frequently occurs in immunocompromised host [4]. Multi-dermatomal zoster involves several adjacent dermatomes, while disseminated cutaneous herpes zoster (DCHZ) is defined as 20 or more vesicular lesions outside the primary and adjacent dermatomes.
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Funding source: Marshfield Clinic Department of Medical Education.
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Conflict of interest: None.
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Reprint requests: John Melski, MD, Marshfield Clinic, 1000 N Oak Ave, Marshfield, WI 54449.