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1.
J Med Case Rep ; 16(1): 127, 2022 Mar 25.
Article in English | MEDLINE | ID: covidwho-1759774

ABSTRACT

PURPOSE: To describe two cases of herpetic anterior uveitis after inoculation of the first dose of Pfizer-BioNTech coronavirus disease 2019 vaccine. METHODS: Case 1: a healthy 92-year-old Caucasian woman developed symptomatic unilateral anterior uveitis for 3 days after Pfizer-BioNTech coronavirus disease 2019 vaccination (Pfizer Inc.). The episode fully resolved with topical and oral antiviral treatment. Case 2: a previously healthy 85-year-old Caucasian woman with left hemicranial signs of herpes zoster infection, associated with herpetic keratouveitis for 3 days after Pfizer-BioNTech coronavirus disease 2019 vaccination. Treatment with topical antibiotics and both oral and topical antiherpetic medication was administered, and she recovered successfully in 5 weeks. CONCLUSION: Clinicians should be aware of the possibility of eye inflammation in the form of herpetic reactivation after coronavirus disease 2019 vaccination.


Subject(s)
COVID-19 , Herpes Zoster , Uveitis, Anterior , Uveitis , Aged, 80 and over , COVID-19 Vaccines/adverse effects , Female , Herpes Zoster/complications , Humans , Uveitis, Anterior/diagnosis , Uveitis, Anterior/drug therapy , Uveitis, Anterior/etiology
3.
Viruses ; 14(2)2022 01 19.
Article in English | MEDLINE | ID: covidwho-1625634

ABSTRACT

The Varicella-zoster virus (VZV) or human herpes virus 3 is a neurotropic human alpha herpes virus responsible for chickenpox/varicella and shingles/Herpes zoster (HZ). This review will focus on HZ. Since HZ is secondary to varicella, its incidence increases with age. In children and youngsters, HZ is rare and associated to metabolic and neoplastic disorders. In adults, advanced age, distress, other infections (such as AIDS or COVID-19), and immunosuppression are the most common risk factors. HZ reactivation has recently been observed after COVID-19 vaccination. The disease shows different clinical stages of variable clinical manifestations. Some of the manifestations bear a higher risk of complications. Among the possible complications, postherpetic neuralgia, a chronic pain disease, is one of the most frequent. HZ vasculitis is associated with morbidity and mortality. Renal and gastrointestinal complications have been reported. The cornerstone of treatment is early intervention with acyclovir or brivudine. Second-line treatments are available. Pain management is essential. For (secondary) prophylaxis, currently two HZV vaccines are available for healthy older adults, a live attenuated VZV vaccine and a recombinant adjuvanted VZV glycoprotein E subunit vaccine. The latter allows vaccination also in severely immunosuppressed patients. This review focuses on manifestations of HZ and its management. Although several articles have been published on HZ, the literature continues to evolve, especially in regard to patients with comorbidities and immunocompromised patients. VZV reactivation has also emerged as an important point of discussion during the COVID-19 pandemic, especially after vaccination. The objective of this review is to discuss current updates related to clinical presentations, complications, and management of HZ.


Subject(s)
Disease Management , Herpes Zoster/drug therapy , Herpes Zoster/prevention & control , Herpesvirus 3, Human/pathogenicity , Herpesvirus Vaccines/immunology , Herpes Zoster/complications , Herpes Zoster/physiopathology , Herpesvirus Vaccines/administration & dosage , Herpesvirus Vaccines/classification , Humans , Immunocompromised Host , Incidence , Latent Infection/virology , Morbidity , Neuralgia, Postherpetic/virology , Risk Factors , Vaccination , Vaccines, Synthetic/administration & dosage
5.
Infection ; 50(2): 289-293, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1527525

ABSTRACT

The first cases of COVID-19 were reported in Wuhan, China, in December 2019. Skin manifestations of COVID-19 vary, among which herpes zoster has recently been found to be associated with the infection. We studied the available literature regarding COVID-19-associated herpes zoster (HZ). We searched the PubMed and Scopus databases for available literature till 20th of May 2021 using the following terms: 'Herpes zoster' or 'Varicella zoster virus' and "COVID-19" or "coronavirus disease" or "SARS-CoV-2". This search revealed 87 publications, of which 29 articles met the inclusion criteria. A total of 29 patients had HZ associated with COVID-19 infection. The patients' ages ranged from 7 to 82 years, averaging 56 years. Thirteen patients (45%) were men and 16 (55%) women. We summarized the demographic data, clinical data, comorbidities, treatment used, lymphocyte count, and distribution and timeline of HZ rash in COVID patients. Lymphopenia was prevalent in 86.6% of patients (where lymphocyte data were available). We discuss possible causes of HZ due to COVID-19. More and larger studies are needed to confirm any relationship between these two infections; however, this study may pave the way for similar studies on this topic.


Subject(s)
COVID-19 , Herpes Zoster , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/complications , Child , China , Female , Herpes Zoster/complications , Herpes Zoster/epidemiology , Herpesvirus 3, Human , Humans , Male , Middle Aged , SARS-CoV-2 , Young Adult
6.
Am J Case Rep ; 22: e934658, 2021 Nov 17.
Article in English | MEDLINE | ID: covidwho-1524601

ABSTRACT

BACKGROUND Ramsay Hunt syndrome is a rare form of herpes zoster caused by the reactivation of the varicella-zoster virus in the geniculate ganglion. The main clinical manifestations are peripheral facial palsy, vesicular rash in the ear, and ipsilateral auricular pain, and sometimes vertigo. COVID-19 is a new multisystemic infectious disease that, in addition to common respiratory manifestations, it is known to affect the immune system, primarily depressing cellular immunity. CASE REPORT A 54-year-old woman was admitted to our hospital with an acute vestibular syndrome and diplopia. She had been diagnosed 3 years prior with interstitial lung disease for which she was taking methylprednisolone. At admission, she tested positive for SARS-CoV-2. In the following days, she developed a sixth nerve palsy on the left side and a right peripheral facial palsy on the right side, followed by a typical zoster rash on the ipsilateral ear. One month later, she developed acute severe hearing loss on the right side. There were no COVID-19 symptoms during her stay in our hospital. The MRI showed Gd enhancement of both facial nerves. Under antiviral and corticoid treatment, the evolution was favorable, with marked improvement at 6 months. CONCLUSIONS COVID-19 increases the risk for herpes zoster infection, probably through induced depression of the cellular immunity. Our case suggests Ramsay Hunt syndrome can be the presenting symptom and sometimes the only symptom of COVID-19. This also seems to be true for other cranial neuropathies, and we recommend testing these patients even if there are no other manifestations.


Subject(s)
COVID-19 , Herpes Zoster Oticus , Herpes Zoster , Polyneuropathies , Female , Herpes Zoster/complications , Herpes Zoster/diagnosis , Herpes Zoster Oticus/diagnosis , Herpes Zoster Oticus/drug therapy , Humans , Middle Aged , SARS-CoV-2
7.
Int J Dermatol ; 61(3): 379-380, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1522708
8.
BMJ Case Rep ; 14(10)2021 Oct 19.
Article in English | MEDLINE | ID: covidwho-1476414

ABSTRACT

Herpes zoster reactivation is a frequently encountered condition that can result in several uncommon complications. This case report highlights one such frequently overlooked complication, segmental zoster paresis. We discuss a case of prolonged fever and lower limb weakness in an immunocompromised patient with breast cancer on active chemotherapy after resolution of a herpetiform rash in the L2, L3 and L4 dermatomes. Early investigation with lumbar puncture, looking for cerebrospinal fluid pleocytosis, varicella zoster virus detection by PCR or molecular testing and immunoglobulins against varicella zoster virus, should be undertaken to support the diagnosis. Nerve conduction studies, electromyography and MRI of the spine can sometimes help with neurolocalisation. Intravenous acyclovir and a tapering course of steroids can help with resolution of symptoms. The variegate presentation can make diagnosis challenging. Awareness and a high index of suspicion can prevent delays in diagnosis and treatment and improve patient outcomes.


Subject(s)
Herpes Zoster , Acyclovir/therapeutic use , Herpes Zoster/complications , Herpes Zoster/diagnosis , Herpes Zoster/drug therapy , Herpesvirus 3, Human , Humans , Immunocompromised Host , Paresis/etiology
14.
15.
J Dermatolog Treat ; 33(2): 1123-1125, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-599301

ABSTRACT

Different skin presentations and patterns of cutaneous signs were reported in COVID19 patients. Varicella-zoster virus (VZV) infection is responsible for two very common skin conditions. Varicella (chickenpox) is the initial presentation for infection with VZV and is characterized by a diffuse vesicular rash. It is after this initial attack, that VZV remains latent in the dorsal root ganglia before reactivating to present as herpes zoster (HZ) in middle age groups. Cutaneous skin findings remain to be emerging every day as a marker or a complication of COVID 19. We report a case of HZ complication in a 44 years old COVID 19 positive male.


Subject(s)
COVID-19 , Herpes Zoster , Adult , COVID-19/complications , Herpes Zoster/complications , Herpes Zoster/diagnosis , Herpes Zoster/drug therapy , Herpesvirus 3, Human , Humans , Male , Middle Aged
16.
Eur J Neurol ; 27(9): 1748-1750, 2020 09.
Article in English | MEDLINE | ID: covidwho-361390

ABSTRACT

BACKGROUND: Varicella-zoster virus (VZV) is a human neurotropic virus that remains in a latent state within ganglionic neurons throughout the entire neuroaxis after the primary infection. When herpes zoster (HZ) leads to trigeminal involvement, the ophthalmic division is the most implicated. COVID-19 has emerged as a viral cause of severe acute respiratory syndrome that has spread all over the world in the last months. Co-infection with COVID-19 and other viruses has been reported, but sparsely, and involving the respiratory viruses. METHODS: The case of a co-infection of COVID-19 with VZV is reported, and the literature reviewed. RESULTS: A 39-year-old immunocompetent man presented with oligosymptomatic infection with COVID-19, which evolved to left facial HZ, affecting the three divisions of the trigeminal nerve. The co-infection was remotely registered, being the respiratory viruses, especially influenza, the most commonly cited association. However, the present case illustrates the emergence of a latent virus infection, which might be favored by the inflammatory response to the former agent (COVID-19). This reaction ascended from the nasal cavity, where trigeminal branches are also placed. CONCLUSIONS: The emergence of latent VZV infection in this rare presentation might illustrate an effect, at least locally, of COVID-19. This virus possibly induced a retrograde reactivation of VZV in a young immunocompetent patient.


Subject(s)
COVID-19/complications , Herpes Zoster/complications , Trigeminal Nerve Diseases/etiology , Adult , Coinfection , Humans , Male
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