Case Of Herpes Zoster Ophthalmicus Research Articles

Outcomes of Treating a late case of Herpes Zoster Ophthalmicus masquerading as Orbital Cellulitis: A Case Report

Abstract
 Introduction : Herpes zoster ophthalmicus (HZO) refers to a reactivated varicella-zoster virus involving the V1 nerve division. Although rare, previous reports have mentioned HZO cases masquerading as orbital cellulitis (HZO-OC). This report depicts the use of acyclovir, corticosteroids and citicoline in our HZO-OC patient with treatment delay.
 Case Illustration : A healthy 66 year old man presented to our clinic 4 weeks after signs of orbital cellulitis followed by vesicular rash following the CN V(1) dermatome were felt which was untreated. The right palpebra was edematous and erythematous. Hazy cornea, mixed injection, grade IV reverse RAPD, diminished direct and consensual reflex and external ophthalmoplegia of the right eye were noted. The diagnosis of HZO-OC with multiple cranial neuropathies OD was established. Topical and symptomatic treatment were given resulting no improvement. Ptosis of the right palpebra became present. The patient was then given systemic acyclovir, methylprednisolone and citicoline. Ophthalmoplegia improved after 2 months and ptosis improved after 4 months.
 Discussion : The use of systemic acyclovir and corticosteroids in HZO-OC patients were given promptly in previous literature. Multiple cranial nerve in our patient was thought to occur due to treatment delay. As improvement was not noted after topical treatment, these systemic treatments along with citicoline were added. Citicoline was added due to its ability to promote neural regeneration.
 Conclusion : Systemic acyclovir, corticosteroids and citicoline may still be beneficial for HZO-OC patients with delayed treatment.

A rare case of herpes zoster ophthalmicus with the onset presenting as headache

The article presents a rare case of herpes zoster ophthalmicus with headache as a first symptom, and discusses clinical presentation, diagnosis and treatment in the context of clinical experience and published literature.

Case report: a rare case of Herpes zoster Ophthalmicus with simultaneous impairment of lumbar and sacral dermatomes

Herpes zoster (HZ) occurs as a result of the reactivation of varicella-zoster virus and is characterized by neuralgic pain, constitutive symptoms, pruritus and dysesthesia along nerve pathways. Vesicles on an erythematous base in a dermatome can be identified, and vision loss may occur in cases of ocular involvement. HZ is clinically diagnosed and treated with antivirals. This study aims to report a rare case of HZ simultaneously affecting the ophthalmic branch of the trigeminal nerve and the lumbar and sacral dermatomes. The patient was clinically cured after treatment with acyclovir for 7 days and did not present other complications.

A conventional case of herpes zoster ophthalmicus with curious findings

A 49-year-old female presented with complaints of right-sided headache, right eye severe pain, and diminution of vision since 1 month. Examination revealed healed skin rashes over the right side of the forehead, right upper lid mechanical ptosis, unilateral restriction of movements, corneal edema, total hyphema, and thickening of retino-choroido-scleral (RCS) complex with subtenon fluid on ultrasonography. A diagnosis of herpes zoster uveitis with total hyphema with posterior scleritis was considered. She was started on topical steroids and intraocular pressure (IOP) lowering agents. But, she was lost to follow up and 6 months later, the eye was phthisical. Here, we present a relatively rare case of herpes zoster ophthalmicus (HZO) with hyphema and posterior scleritis.

An acute case of herpes zoster ophthalmicus with post-herpetic neuralgia and cranial nerve neuropathies

Herpes zoster is a common diagnosis in the emergency department which is caused by reactivation of varicella zoster virus (VZV). Reactivation in ophthalmic division of trigeminal nerve causes Herpes zoster ophthalmicus. It is associated with a rash in the distribution of the trigeminal nerve dermatomes especially in ophthalmic and maxillary divisions. The most often complications of HZO are episcleritis, keratitis, glaucoma, and cataracts. HZO with cranial neuropathy is a very rare condition. So herewith we report a case 51 years old female with swelling, redness in right eye and drooping of eyelids on the right side. She had tearing and double vision. She was diagnosed with herpes zoster ophthalmicus with neuropathy of 3rd, 4th and 6th cranial nerves. The patient was treated and discharged in a healthy condition. Timely diagnosis and treatment can decrease morbidity and prevent the complication.

A Case Report on Herpes Zoster Ophthalmicus with Postherpetic Neuralgia

Herpes Zoster Ophthalmicus (HZO), also known as Ophthalmic Zoster, caused by the reactivation of the Varicella Zoster Virus (VZV), VZV reactivation commonly affects the ophthalmic division of the trigeminal nerve and subsequently the eye. HZO is considered an ophthalmologic emergency. The most common complication of HZO is postherpetic neuralgia (PHN). HZO is a diagnosed based on history and cutaneous findings. Antivirals medications such as acyclovir, valacyclovir and famciclovir remain the mainstay of therapy for HZO. HZO represents approximately 10 to 25% of all cases of herpes zoster. Here, we report an interesting case of HZO and it's complication PHN in a 61 years old male patient.

Herpes Zoster Ophthalmicus Following Covid-19 Vaccination: A Case Report

Herpes zoster ophthalmicus is a manifestation of herpes zoster infection, typically with eye symptoms. We report a case of herpes zoster ophthalmicus in a patient who had recently received the Johnson & Johnson COVID-19 vaccine. There have been other case reports of HZO in patients who recently got the same vaccine

Herpes zoster following BNT162b2 mRNA COVID-19 vaccination in patients with autoimmune inflammatory rheumatic diseases: a case series.

ObjectivesAs global vaccination campaigns against COVID-19 disease commence, vaccine safety needs to be closely assessed. The safety profile of mRNA-based vaccines in patients with autoimmune inflammatory rheumatic diseases (AIIRD) is unknown. The objective of this report is to raise awareness to reactivation of herpes zoster (HZ) following the BNT162b2 mRNA vaccination in patients with AIIRD.MethodsThe safety of the BNT162b2 mRNA vaccination was assessed in an observational study monitoring post-vaccination adverse effects in patients with AIIRD (n = 491) and controls (n = 99), conducted in two Rheumatology Departments in Israel.ResultsThe prevalence of HZ was 1.2% (n = 6) in patients with AIIRD compared with none in controls. Six female patients aged 49 ± 11 years with stable AIIRD: rheumatoid arthritis (n = 4), Sjogren’s syndrome (n = 1), and undifferentiated connective disease (n = 1), developed the first in a lifetime event of HZ within a short time after the first vaccine dose in 5 cases and after the second vaccine dose in one case. In the majority of cases, HZ infection was mild, except a case of HZ ophthalmicus, without corneal involvement, in RA patient treated with tofacitinib. There were no cases of disseminated HZ disease or postherpetic neuralgia. All but one patient received antiviral treatment with a resolution of HZ-related symptoms up to 6 weeks. Five patients completed the second vaccine dose without other adverse effects.ConclusionEpidemiologic studies on the safety of the mRNA-based COVID-19 vaccines in patients with AIIRD are needed to clarify the association between the BNT162b2 mRNA vaccination and reactivation of zoster.

A Case of Herpes Zoster Ophthalmicus with Ocular Involvement in an Immunocompromised Patient

Herpes Zoster (HZ) is a viral infection of an individual nerve and its corresponding dermatome following reactivation of latent varicella zoster virus (VZV). Approximately 1 in 4 people will develop herpes zoster in their lifetime, with incidence and severity increasing with age. Other important risk factors for VZV include an immunocompromised state, certain comorbidities, psychological factors and female sex. This article presents a case of Herpes Zoster Ophthalmicus with ocular involvement in an immunocompromised 64-year-old male patient.

Blistering Beetle Dermatitis Mimicking Herpes Zoster Ophthalmicus: a Case Report

Abstract Blistering beetle dermatitis is an important dermatological disease of tropical countries. Although the clinical features are classical, little awareness amongst medical practitioners may cause difficulties in the diagnosis of this condition. Further, it may sometimes mimic an unrelated disease which can lead to delay in treatment causing prolonged suffering of the patient. We present a case of blistering beetle dermatitis that was initially misdiagnosed as a case of herpeszoster ophthalmicus. The case is presented to reinforce awareness on this dermatologicaldis-ease and discuss its atypical presentation and its management.

Herpes zoster ophthalmicus in a healthy Nigerian child

Herpes zoster ophthalmicus (HZO) is rare in children especially those who are immunocompetent. We reported a case of HZO in a healthy 3-year-old girl with no history of exposure or underlying immune-compromising systemic disease. She developed severe ocular complications after treatment. Both parents were non-reactive to human immunodeficiency virus (HIV) I and II.

Multidermatomal herpes zoster ophthalmicus in an immunocompetent male

Herpes zoster (HZ) is caused by varicella zoster virus, which most commonly affects the thoracic (45%), cervical (23%), and trigeminal nerve (15%). Multidermatomal involvement is rare in an immunocompetent patient. We report an unusual case of HZ ophthalmicus involving all three divisions of trigeminal nerve including the superficial cervical plexus in an immunocompetent male. We recommend in such situation patient should be followed up to ensure earlier tests were not done during the window period.

An interesting case of herpes zoster ophthalmicus

Approximately 20% of the world's population suffers from herpes zoster at least once in a lifetime, with about 10% to 20% of these having an ophthalmic involvement. Timely diagnosis of Herpes Zoster Ophthalmicus (HZO), with an early recognition of its various associated complications as well as their management along with an early referral to an ophthalmologist are critical in limiting visual disability. Here we report an interesting case of HZO in a young individual who in addition to the corneal involvement also had anterior uveitis as well as grossly raised intra ocular pressure

A Young Boy with Painful Eye Swelling and Facial Rash

Oculomotor palsy is a recognized uncommon complication in herpes zoster ophthalmicus. A case of herpes zoster ophthalmicus with ophthalmoplegia is reported. A 15 year old boy presented with ptosis, chemosis, proptosis, ophthalmoplegia involving IVth and VIth cranial nerve following vesicular eruption on his right forehead. He was treated with oral acyclovir and oral steroids. He made a partial recovery with improvement of ptosis, proptosis but with residual VIth nerve palsy. Keyword: Herpes zoster ophthalmicus; ocular herpes zoster; ophthalmoplegia; BangladeshDOI: 10.3329/jom.v12i1.6938J Medicine 2011; 12 : 91-93

A Case of Herpes Zoster Ophthalmicus with Isolated Trochlear Nerve Involvement

BackgroundHerpes zoster ophthalmicus (HZO) can involve the oculomotor nerve; however, isolated trochlear nerve palsy has rarely been reported.Case ReportAn 83-year-old man who suffered from HZO in the right frontal area and scalp subsequently developed vertical diplopia and severe pain. Cerebrospinal fluid examination and brain MRI revealed no abnormalities. Isolated right trochlear nerve palsy was diagnosed based on the findings of neuro-ophthalmological tests.ConclusionsIsolated trochlear nerve involvement associated with HZO is very rare and may be easily overlooked. Physicians should carefully examine oculomotor involvement in HZO.

Ophthalmic Herpes Zoster in an 18-Month-Old Child

We present a case of herpes zoster ophthalmicus in an 18-month-old child. Early exposure to varicella zoster virus while being breast-fed appears to account for this clinical presentation. The incidence of herpes zoster in children younger than age 2 years is discussed. J Pediatr Ophthalmol Strabismus 2005;42:57–58.

A Case of Acute Dacryoadenitis Associated with Herpes Zoster Ophthalmicus

Background: Acute dacryoadenitis is an uncommon disease. Case: We present what we believe to be the first reported case of herpes zoster ophthalmicus with the onset of acute dacryoadenitis. Observations: A 30-year-old man complained of severe ocular pain and hyperemia in his right eye. Magnetic resonance imaging (MRI) demonstrated enlargement of the right lacrimal gland and acute dacryoadenitis was diagnosed. Two days after treatment with systemic antibiotics he developed iridocyclitis and skin lesions confined to the first division of the trigeminal nerve; therefore, herpes zoster ophthalmicus was diagnosed. Treatment with acyclovir immediately resolved the ocular pain and swelling of the upper eyelid. MRI conducted in the 4 months after the initial examination showed there was no longer enlargement of the right lacrimal gland. Conclusion: Clinicians should be aware that varicella-zoster virus may cause acute dacryoadenitis.

MRI evaluation of a case of herpes zoster ophthalmicus with delayed contralateral hemiplegia

We report the case of a patient affected by contralateral hemiplegia during herpes zoster ophthalmicus (HZO) evaluated both with serial CT scans and with MRI. We suggest that MRI examination of patients affected by HZO could be useful for the detection of early signs of cerebral arterial damage which are not yet clinically and radiologically apparent.

Herpes zoster ophthalmicus mit nachfolgender Okulomotoriusparese und homolateralem Media-Infarkt

Oculomotor palsy is a well-known complication of herpes zoster ophthalmicus (HZO). Combination with homolateral cerebral media infarction and contralateral hemiplegia is very rare. Since the first paper on HZO and cerebral ischemia was published, in 1919, about 70 cases have been described. Zoster infection is thought to encroach from the fifth cranial nerve on to a cerebral artery at the base of the brain. The authors describe a case of HZO seen by them, with oculomotor palsy and ipsilateral media infarction with contralateral hemiplegia and aphasia. A review of the literature is given and etiologic and therapeutic aspects are discussed.

HERPES ZOSTER TREATED WITH ACTH

Within the past four months I have had occasion to observe five cases of herpes zoster treated with ACTH. Three of the patients were over 50 years of age. All had relief of pain by the time they had received the third injection of ACTH. Usually 10 to 15 mg. was given at six-hour intervals. The relief had continued for two to four months, to the time of writing. One was a case of herpes zoster ophthalmicus. The course of the disease as far as the skin picture is concerned was unaltered.