Ayurvedic management of co-infection of Herpes zoster ophthalmicus in COVID-19 patient: A case report

Abstract

COVID-19 patients have cutaneous manifestations such as herpes zoster, urticaria, chilblains, purpura, livedo racemosa, chickenpox-like eruptions in very small percentage. However, the major focus is on pulmonary and cardiac symptoms as it leads to increased mortality. Globally, many cases of herpes zoster as coinfection of COVID-19 are observed. Here, a 65-year-old female with Herpes Zoster Ophthalmicus (HZO) managed by Ayurveda stand-alone treatment is reported. She tested RT-PCR (Real-Time Polymerase Chain Reaction) positive, had mild COVID-19 symptoms, and preferred home isolation and Ayurveda treatment. The patient was monitored twice daily through teleconference (zoom/video calls), photographs of the condition were procured, and guidance was sent in return. Initially, the patient complained of fever, pain, and burning sensation in scalp, left ear, and eye with left periorbital swelling. Once the fever subsided, the patient developed vomiting and loose stools as COVID-19 symptoms. There was complete relief from all the symptoms in four weeks, and the medicines for the postherpetic lesions were continued for another week. Treatment of herpes coinfection in COVID-19 under home isolation is in itself a challenge requiring leech application. However, the case was managed with Ayurveda oral medications and topical therapies such as Seka and Bidalaka to achieve relief from pain, burning sensation, and swelling. The drugs and therapies used in the above case assisted increasing circulation relieving pain thereby, assuring good sleep and faster respite from all symptoms. This case is reported to add to clinical literature and to showcase the importance of local therapies and teleconsultation in condition like HZO associated with COVID-19.