Abstract
BackgroundBilateral herpes zoster (BHZ) is an atypical presentation of herpes zoster (HZ), with few cases reported before. Ramsay Hunt syndrome (RHS) is an uncommon complication of VZV infection. Cases of BHZ with RHS in immunocompetent adults have been reported rarely.Case presentationWe described an immunocompetent adult who suffered from left-sided thoracic herpes zoster and contralateral RHS simultaneously, and summarizes the characteristics of BHZ.ConclusionsCases of BHZ with RHS in immunocompetent adults have not been reported previously. Antivirus - glucocorticoid combination therapy showed a good effect in this case.
Highlights
Herpes zoster (HZ) is a common infection caused by the varicella-zoster virus (VZV), usually happened in patients in hypoimmunity
When bilateral dermatomes are involved, called bilateral herpes zoster (BHZ), which is an atypical presentation of HZ, it has an incidence rate under 0.1% and is usually found in immunosuppressed or senile patients [3], it happened when VZV escapes unexpectedly from cellular immunity in healthy people
We have reviewed literature and found 40 cases of Bilateral herpes zoster (BHZ) have been reported, as illustrated in Table 1. (References can be found in the Supplement 1), The data of those cases was organized with attributes of age, gender, involving dermatomes, underlying diseases, and treatments
Summary
Herpes zoster (HZ) is a common infection caused by the varicella-zoster virus (VZV), usually happened in patients in hypoimmunity. Case report A 55 year-old-male presented to the dermatology clinic with diffused erythema and clustered vesicles affecting the left chest and right ear (Fig. 1a, b). He complained severe pain in the affected region. The patient was not performed virology tests because the disease could be diagnosed based on typical clinical manifestations He received the treatment of penciclovir 250 mg twice by dripping and methylprednisolone 40 mg once daily. Pain relief with oral gabapentin and super laser irradiation By using this therapy for 1 week, vesicles over the right ear and left chest had been absorbed and crusted. After 2 months follow-up, this patient could close his right eyelid completely, flattened nasolabial fold, and droopy corner of the mouth on his right side has been improved. (Fig. 2)
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