Primary Varicella Zoster Infection Research Articles

Overlapping Miller Fisher Syndrome Following Primary Varicella Zoster Infection: A Case Report

Overlapping Miller Fisher Syndrome Following Primary Varicella Zoster Infection: A Case Report

Varicella zoster infection showing Koebner phenomenon.

Koebner phenomenon or isomorphic response describes the appearance of new skin lesions on areas of previously unaffected skin secondary to trauma. It is very rarely described in chickenpox. Here we describe a case of primary varicella zoster infection showing Koebner phenomenon.

Dysgeusia

Bitter taste dysgeusia is a rare symptom where patients experience all foods as bitter. While its cause is still unknown, it has been increasingly reported in infections. The altered taste sensation associated with herpes zoster infection is not uncommon. However, it is rare in primary varicella infections. In this case report, we present what we believe to be the first case of bitter taste dysgeusia presenting as a prodromal symptom in primary varicella zoster infection.

Primary varicella zoster infection compared to varicella vaccine reactivation associated meningitis in immunocompetent children.

We diagnosed varicella zoster virus (VZV) meningitis in a healthy adolescent boy who presented without a rash or fever. We aim to compare VZV reactivation meningitis in children after primary VZV infection and VZV vaccination. We reviewed the literature up until June 2020 using Pubmed/MEDLINE and EMBASE databases using 'varicella zoster', 'meningitis' and 'children' as keywords. Only English articles were included. Twenty-five cases were included in this review. Children who had VZV reactivation meningitis after vaccination were younger (7 ± 3.4 years vs. 11.9 ± 3.6 years, P = 0.0038), had a shorter interval between first exposure to reactivation (5.6 ± 2.9 years vs. 8.8 ± 3.2 years, P = 0.018) and more likely to have a rash (100% vs. 55%, P = 0.04). VZV reactivation meningitis occurs after both primary VZV infection and VZV vaccination. The absence of exanthem, fever or meningism does not rule out VZV meningitis.

The different symptoms determining management of hand foot and mouth disease and primary varicella zoster infection

Background: Hand, foot and mouth disease (HFMD) is a medical condition endemic among children in South-East Asia, including Indonesia and, more specifically, Banjarmasin – the capital of South Sulawesi. The disease is mediated by Enterovirus 71 and Coxsackievirus 16 which attack the oral cavity, hands, feet, buttocks and genital areas. One differential diagnosis of this disease is Primary Varicella Zoster infection. Both diseases have similar clinical symptoms but different etiologies which can precipitate errors in the administration of therapy Purpose: To elucidate the distinction between HFMD and Primary varicella zoster infection. Case: An 8 year-old male sought treatment complaining of ulcers on the upper maxillary gingiva followed by the appearance of itchy and painful lesions affecting the nose, upper lip, hands and feet. The patient’s mother reported his history of 39oC fever followed by the development of red spots and ulcers on the face, hands and feet which caused itching. Clinically, it is similar to Primary varicella zoster infection which can affect any part of the body. The patient only used an immunomodulator once a day and was actively seeking available healthcare. Case management: Extraoral examination confirmed the presence of multiple erythematous vesicles and ulcers, 2 mm in diameter, which caused a sensation of itching around the nose and upper lip region. Multiple painful and itchy red macules and vesicles, 3-6 mm in diameter, appeared not only on the patient’s palms, back of the hands and feet. Intraoral examination of the right maxillary gingiva revealed multiple painful ulcers, 1-2 mm in diameter and yellowish in appearance, surrounded by erythema. The results of history-taking implied that no lesions appeared on other parts of the body. Conclusion: While these conditions share similar clinical manifestations, their contrasting etiologies require different treatments. The ultimate diagnosis can be determined clinically by the dentist, thereby preventing errors in the administration of therapy.

Postinfectious (Varicella Zoster) myositis and mixed polyneuropathy

We present a case of a 21-year-old male with weakness of all four limbs after primary episode of chicken pox. Nerve conduction studies and magnetic resonance imaging dorsal spine with whole spine and brain screening confirmed polyneuropathy and myositis, respectively. He responded well to intravenous steroids, with complete reversal of symptoms. This case shows that primary varicella zoster infection is a sufficient stimulus to drive antibody generation and precipitate clinical complications.

Spontaneous splenic rupture complicating primary varicella zoster infection: a case report

BackgroundPrimary varicella zoster virus (VZV) infection is a common illness, predominantly affecting children. Its course is typically benign, although severe complications have been described. Splenic rupture is an extremely rare and potentially fatal complication of primary VZV infection, with only a handful of cases reported in the literature.Case PresentationA 32-year-old Romanian man with no significant past medical history, presented with a 2 day history of sudden onset, worsening generalised abdominal pain and a 1 day history of vomiting. The following day he developed fevers and a generalised widespread erythematous rash consisting of clusters of macules, papules and vesicles at different stages of development. There was no history of sore throat, coryza, arthralgia, myalgia, cough, shortness of breath, weight loss, or night sweats. There was no recent illness and no history of trauma. CT abdomen showed splenic rupture with intra-abdominal haemorrhage. Admission bloods showed anaemia and thrombocytopenia, with haemoglobin 110 g/l and platelets 78 × 109/l. Viral PCR of vesicle fluid from the rash was positive for VZV DNA confirming the clinical diagnosis of primary varicella zoster infection. Viral serology also confirmed recent infection. He was haemodynamically resuscitated, and underwent laparotomy and splenectomy. He was commenced on IV acyclovir and completed a 5 day course. Prior to discharge he was commenced on recommended splenectomy secondary prevention treatment.ConclusionThere are several reported complications of varicella infection, more commonly in the immunocompromised population. Spontaneous splenic rupture is an unusual complication of primary VZV infection. Here we report the sixth known case in the literature. Splenic rupture should be considered in cases of primary varicella in young adults presenting with abdominal pain.

Post-Varicella Acute In ammatory Demyelinating Polyradiculoneuropathy in a 51-year old Filipino Male: A Case Report

Primary varicella zoster infection is commonly observed in school-aged children. There are increasing reports of adults being affected. Varicella zoster infection has a myriad of clinical complication. The rarer of these complications is GuillanBarre syndrome (GBS) or acute inflammatory demyelinatimgpolyradiculoneuropathy, with less than 50 cases in reported literature. Keywords: varicella, acute inflammatory demyelinating polyradiculoneuropathy, GuillanBarre Syndrome

Primary varicella zoster infection associated with fingolimod treatment

The therapy of relapsing-remitting multiple sclerosis (MS) has been revolutionized since the appearance of first-line disease-modifying drugs such as interferon-β and glatiramer acetate. These drugs are associated with moderate efficacy but no life-threatening risks. In contrast, new treatments, which have recently entered the MS scene, have been reported to display a superior efficacy with respect to relapse rate and progression of disability but also an unexpected risk of fatal adverse events.1,2 The oral drug sphingosine-1-phosphate-receptor modulator, fingolimod (FTY720), has been recently shown to have superior efficacy vs IM interferon-β 1a on clinical and MRI outcomes (TRANSFORMS study).3 However, 2 fatal viral infections occurred in patients who received fingolimod, including one case of primary varicella zoster (VZ). Recently, other adverse effects have been reported, mainly affecting the vascular system, such as a case of hemorrhagic focal …

Visceral leishmaniasis reactivation in transplant patients: a minireview with report of a new case

An updated review of cases of reactivated visceral leishmaniasis (VL) in transplant patients is presented, with a new report of a kidney transplant patient who had VL caused by reactivation of a dormant infection contracted 21 years previously. Close to the time of disease reactivation, the patient had a primary varicella-zoster infection.

Primary varicella-zoster infection in patients on biologic therapies for psoriasis

Primary varicella-zoster infection in patients on biologic therapies for psoriasis

Vaginal discharge due to primary varicella

Cervicitis is an important cause of abnormal vaginal discharge. We describe a case of vaginal discharge due to cervicitis caused by primary varicella zoster infection in a patient with chronic immunosuppression. Though a few reports of genital infection due to chicken pox are available, to the best of our knowledge, there are no reports of abnormal vaginal discharge due to cervicitis caused by chicken pox.

Síndrome de necrosis retiniana aguda tras primoinfección por varicela

A 34-year-old male patient developed acute retinal necrosis in his left eye about three weeks after the onset of chickenpox. Systemic antiviral treatment with intravenous acyclovir (10 mg/kg/8 hours) and systemic corticosteroids (1 mg/kg/day) controlled the retinitis and the patient suffered no loss of visual acuity. Acute retinal necrosis is an unusual complication of chickenpox. A mild form of this entity has been described during the course of primary varicella-zoster infection. Adequate and early therapy during the acute phase of the disease with intravenous acyclovir and systemic corticosteroids is recommended to achieve a satisfactory visual acuity and prevent complications.

Granulomatous angiitis following primary varicella zoster infection

Granulomatous angiitis is an uncommon but well recognized complication of varicella zoster infection. The classic presentation is of a delayed hemiparesis in an often immunocompromised patient following zoster ophthalmicus. This report outlines the case of a young woman who developed a large left middle cerebral artery territory infarct secondary to granulomatous angiitis during primary varicella zoster infection.

Herpes Zoster in Childhood: Case Report and Review of the Literature

Herpes zoster in childhood is uncommon even in the setting of known risk factors such as primary varicella zoster infection before 12 months of age and immunocompromised states. We report a 7-year-old, otherwise healthy girl with shingles, and review the risk factors, prognosis, and treatment of pediatric zoster.

Varicella: Pediatric Genital/Rectal Vesicular Lesions of Unclear Origin— Simon & Steele

Three children who presented with localized vesicular rash in the diaper area were found to have primary varicella-zoster infections. Primary varicella can closely mimic genital herpes simplex virus (HSV I or 2), which may be an indicator of sexual abuse. To avoid unfounded investigation for sexual abuse, primary varicella-zoster infection must be included in the differential diagnosis. Direct fluorescent antibody testing is a sensitive and specific diagnostic test that can be used to distinguish HSV 1 or 2 from varicella-zoster. [Simon HK, Steele DW: Varicella: Pediatric genital/rectal vesicular lesions of unclear origin. Ann Emerg Med January 1995;25:111-114.]

Chickenpox-associated Acute Retinal Necrosis Syndrome

Acute retinal necrosis (ARN) syndrome usually occurs as the result of secondary reactivation of latent, previously acquired, varicella-zoster or herpes simplex virus. The authors report four patients who developed a mild form of ARN within 1 month (5 to 28 days) after the onset of chickenpox. In contrast to typical cases of ARN, these cases were less severe, with retinitis limited to two quadrants or less (three patients), no retinal detachment (four patients), minimal vitreitis (four patients), and no loss of visual acuity (four patients). Thus, ARN may occur during the course of primary varicella-zoster infection.

ADENINE ARABINOSIDE THERAPY OF VARICELLA ZOSTER IN IMMUNOCOMPROMISED PATIENTS

Nineteen immunosuppressed patients with varicella zoster were enrolled in a randomized crossover 10 day trial of adenine arabinoside. Of 14 with reticuloendothelial malignancy, 7 were receiving active chemotherapy. Age, sex, underlying disease, and preceding chemotherapy were comparable for both randomization groups. Eight patients received drug over the first 5 days and placebo the next 5; while 11 received the exact opposite regimen. In spite of natural healing in the placebo group, adenine arabinoside significantly accelerated cutaneous healing for the elimination of virus from vesicles (P = 0.015) and cessation of new vesicle formation (P = 0.026). Although pustulation was not statistically accelerated, all treated patients had completely pustulated by the time of crossover. Five patients, all with reticuloendothelial cancer, developed pneumonitis and, because of the crossover received adenine arabinoside during their disease course. The mean duration of pneumonitis was 5.6 days ± 2.1 (range: 3 to 8). Resolution was temporally associated with therapy. There were no study deaths. Clinical and laboratory evidence of toxicity was insignificant at the dose employed. These data for therapy of primary varicella zoster infection support the larger study demonstrating accelerated healing and satisfactory therapeutic index in herpes zoster with adenine arabinoside.