ABSTRACT
El herpes zoster (HZ) constituye una enfermedad de distribución mundial; sin embargo, existen es casos datos comunicados sobre la misma en países de Latinoamérica. Con el objetivo de evaluar aspectos clínicos y epidemiológicos de esta enfermedad en nuestra población, realizamos un análisis retrospectivo de historias clínicas de un centro privado de referencia en enfermedades infecciosas en Buenos Aires, Argentina (período: 2000-2005). Se realizó un análisis estadístico univariado para evaluar los factores asociados a neuralgia posherpética en este grupo de pacientes. Sobre un total de 302 casos evaluables, el 62% correspondieron a mujeres. La mediana de edad fue de 57 años. El 16.1% de los pacientes presentó condiciones predisponentes al desarrollo de zoster. Las localizaciones más frecuentes fueron la torácica, oftálmica y lumbosacra. El 7.75% presentó compromiso de más de dos metámeras. El 94% de los pacientes recibió medicación antiviral, siendo el aciclovir la droga más utilizada. El 94% recibió alguna medicación coadyuvante (antiinflamatorios no esteroideos, antineuríticos, corticoides). La complicación más frecuente fue la neuralgia posherpética (12%) y se encontró estadísticamente asociada a edad mayor de 50 años.
Herpes zoster (HZ) is a public health problem worldwide. Although, there is paucity of data of this disease from South American countries. The objective of this study was to evaluate clinical and epidemiological aspects of HZ in a population of patients from South America. We underwent a retrospective analysis of clinical charts of an infectious diseases reference center (period: 2000-2005). Univariate analysis was performed to assess variables related to post herpetic neuralgia (PHN). From a total of 302 cases, 62% were in women. The median age was 57 years; 16.1% of the patients had a predisposing condition for the development of HZ. Most frequent dermatomes involved were: thoracic, ophthalmic and lumbar; 93.5% of the patients received antiviral drugs and 94% complementary medications. The most frequent complication was PHN and was related with age over 50 years. Clinical and epidemiological aspects of HZ and the frequency of complications in our population were similar to data from developed countries.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Herpes Zoster/epidemiology , Age Distribution , Analysis of Variance , Acyclovir/therapeutic use , Antiviral Agents/therapeutic use , Argentina/epidemiology , Herpes Zoster/complications , Herpes Zoster/drug therapy , Neuralgia, Postherpetic/etiology , Retrospective StudiesABSTRACT
O presente artigo busca informar o médico generalista sobre os aspectos clínicos da infecção causada pelo vírus varicela zoster. O autor cita o comportamento viral de inatividade nos gânglios das raízes dorsais e as causas prováveis para sua reativação, tais como idade avançada, ou extremamente precoce, doenças do sistema imunológico e determinados tumores entre outras circunstâncias, que são capazes de propiciar condições para a reinfecção conhecida como herpes zoster, cujas características clínicas são também apresentadas, bem como seu diagnóstico e tratamento. As complicações neurológicas relacionadas à infecção pelo vírus varicela zoster são estudadas no artigo. É feita, ainda, a conceituação da neuralgia pós-herpética, e a atualização da abordagem terapêutica deste tipo de dor neuropática. São estudados os vários fatores fisiopatológicos responsáveis por sua gênese, cujo conhecimento fundamenta o tratamento medicamentoso eficiente.
The aim of the present article is to inform the internist on the clinical aspects of the varicella zoster virus infection. The author refers the viral inactivity behavior, harbored in the dorsal root ganglia. The probable causes to its reactivation are mentioned, such as advanced or very precocious age, immunocompromised states and some tumors among other circunstances. These conditions are capable to create the right enviromnent to the reinfection, called herpes zoster, whose clinical aspects, diagnosis and treatment are presented. The neurological complications related to the Varicella Zoster Virus infection are studied in the article. The post herpetic neuralgia is defined as a specific type of naturopathic pain. The author brings up to date the therapeutical approach of the painful condition caused by herpes zoster and emphasizes the significance of understanding the post herpetic neuralgia pathophysiologic mechanisms to its effective treatment.