汎発疹を伴った喉頭帯状疱疹―粘膜疹の有無による病態の考察―

Abstract

The 2 types of laryngeal disorder related to varicella zoster virus infection are differentiated by the presence or absence of mucosal spots. We report a case of herpes zoster localized in the right laryngeal mucosa. A 71-year-old woman having 2-days history of severe pain on swallowing without satisfactory response to an antibiotic was found in laryngeal fiberscopy to have laryngeal mucosa on the right side with white coating. Vocal cord movement was intact. She was diagnosed with laryngeal zoster bread on hemilateral mucosal eruptions accompanied by severe pain. The day after taking acyclovir, generalized zoster without itching or pain appeared on the anterior and posterior head, chest, abdomen, and back. Laryngeal mucosal spots and generalized zoster disappeared without sequelae within 4 to 5 days. A review of the literature showed that almost all laryngeal disorders without mucosal eruption included laryngeal palsy and other cranial or cervical nerve injury. Laryngeal disorders with mucosal spots are divided into those with laryngeal palsy and other nerve injuries and those with intact vocal cord function. We concluded that laryngeal disease without mucosal spots results from neuropathy due to intracranial or cranial basement disorders. We also concluded that laryngeal disorders with mucosal spots and normal vocal cord movement result from direct herpes zoster virus invasion through the upper laryngeal nerve from the nodosal ganglion.