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Segmental zoster paresis as a cause for persistent fever in an immunocompromised patient.
Murali Govind, Renuka; Cao, Yun.
  • Murali Govind R; Department of General Medicine, Tan Tock Seng Hospital, Singapore rnk.mgnair@gmail.com.
  • Cao Y; Department of General Medicine, Tan Tock Seng Hospital, Singapore.
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.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Herpes Zoster Subject: Herpes Zoster Type of study: Case report / Diagnostic study / Etiology study Language: English Clinical aspect: Prognosis / Therapy Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Herpes Zoster Subject: Herpes Zoster Type of study: Case report / Diagnostic study / Etiology study Language: English Clinical aspect: Prognosis / Therapy Year: 2021
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