Disseminated herpes zoster involving bladder and severe inappropriate antidiuretic hormone in a immunocompetent elderly patient - A case report -

Abstract

Disseminated herpes zoster commonly occurs in patients with decreased immunity, but rarely in patients without any evidence of immunosuppression. We reported a case of disseminated herpes zoster with visceral organ involvement in a non-immunocompromised patient. An 83-year-old man visited our pain center, with chief complaints of painful rashes on the L3-L4 and S2-S4 due to acute herpes zoster. Even though intravenous antiviral therapy was initiated immediately upon hospitalization, his lesion deteriorated and systemic cluster formed. Urinary retention and hyponatremia occurred, and he was diagnosed with zoster cystitis and severe inappropriate antidiuretic hormone syndrome. Conservative treatment, including Foley catheter insertion and correction of hyponatremia with antiviral therapy, was initiated, and he was discharged without any complications at the 33rd day of hospitalization. Old age can be a risk factor of disseminated herpes zoster, and visceral organ involvement should also be considered. Keywords: Cystitis; Herpes zoster; Hyponatremia; Immunocompetence; Inappropriate ADH Syndrome; Urinary retention