11/141. Acute abdomen without cutaneous signs of varicella zoster virus infection as a late complication of allogeneic bone marrow transplantation: importance of empiric therapy with acyclovir.Two patients complained of severe abdominal pain as the first sign of varicella zoster virus infection about 1 year after allogeneic BMT. In case 1, eruptions, found on the face and chest on admission, became vesicular and dispersed on the third hospital day. Though acyclovir (ACV) was immediately started, he died on the fourth day. In case 2, skin rash was never observed during the clinical course. laparotomy on the third hospital day revealed many hemorrhagic spots on the liver surface and mucous membrane of the upper GI tract, indicating disseminated visceral disease. Empiric therapy with ACV was successful.- - - - - - - - - - ranking = 1keywords = pain, abdominal pain, chest, upper (Clic here for more details about this article) |
12/141. herpes zoster in the elderly: issues related to geriatrics.This article reviews specific clinical and research issues of herpes zoster related to geriatric medicine. Salient epidemiological and clinical issues include the increasing probability of zoster and postherpetic neuralgia with aging, age-related decline in immunity to varicella-zoster virus, the functional and psychosocial impact of zoster on the quality of life of the elderly, illness behavior in elderly patients with zoster, and varicella-zoster virus transmission and control in the nursing home. The role of antiviral therapy, corticosteroids, and analgesics; the measurement and analysis of pain, health-related quality of life, and functional status; and development of the varicella vaccine in the management of zoster in the elderly are also emphasized. Fertile research opportunities exist within these areas for investigators interested in infectious diseases, geriatrics, and other zoster-related disciplines.- - - - - - - - - - ranking = 0.7634440678059keywords = pain (Clic here for more details about this article) |
13/141. Giant cell lichenoid dermatitis within herpes zoster scars in a bone marrow recipient.Cutaneous lesions arising in herpes zoster (HZ) scars are rare. We report a 34-year-old woman with acute lymphoblastic leukemia underwent allogenic bone marrow transplant (BMT). Ten days after the BMT, she developed clusters of vesicles over the right neck, scapula, shoulder and chest. She was treated with intravenous acyclovir and foscarnet. One month after the vesiculous episode of HZ she showed 5 mm to 2 cm clustered flat violaceous lichenoid papules and confluent plaques within the HZ scars. Histopathologic examination revealed a inflammatory infiltrate present in the papillary dermis with granulomatous aggregated formed by histiocytes, multinucleated giant cells and lymphocytes. She was treated with topic steroids with significant improvement. Pathologic findings are similar to those of an unusual lichenoid reaction named "giant cell lichenoid dermatitis". We present the first reported case of giant cell lichenoid dermatitis at the sites of HZ scars.- - - - - - - - - - ranking = 0.01862046566039keywords = chest (Clic here for more details about this article) |
14/141. A study of post-traumatic shingles as a work related injury.BACKGROUND: After chicken pox, the herpes varicella-zoster (HVZ) virus may remain dormant in the dorsal root ganglion until later reactivation causes shingles, characterized by painful dysesthesias and cutaneous vesicular eruptions along a unilateral dermatome. Shingles as a work-related injury has not been previously addressed in the medical literature. Case history We present a 50-year old female hospital employee who, while working, sustained an acute, traumatic hyperextension injury to her right wrist, hand, and fingers. Although she initially responded to treatment for flexor tendinitis, she suddenly developed shingles in the right C5-C6 dermatomes. She was treated with famcyclovir and her skin lesions resolved, but post-herpetic neuralgia persisted. CONCLUSIONS: It was felt that her shingles was causally related to her occupational injury since trauma (previously reported to precipitate shingles) was her only risk factor and the timing and location of the lesions corresponded closely to the occupational injury. In addition to appropriately diagnosing and treating their patients, workers' compensation physicians often must determine if a particular condition was caused by the original work-related incident. Clinicians who treat trauma patients and injured workers should be aware of post-traumatic shingles and understand the causal relationship of this uncommon but clinically important phenomenon.- - - - - - - - - - ranking = 0.7634440678059keywords = pain (Clic here for more details about this article) |
15/141. Inappropriate antidiuretic hormone secretion, abdominal pain and disseminated varicella-zoster virus infection: an unusual triad in a patient 6 months post mini-allogeneic peripheral stem cell transplant for chronic myeloid leukemia.Severe abdominal pain followed by inappropriate antidiuretic hormone secretion (SIADH) preceding by several days the skin manifestation of varicella-zoster virus (VZV) infection in an immunocompromised patient is described. This is a rare presentation of a severe infection described previously only once in a chronic myeloid leukemia (CML) patient 5 months post allo-BMT during immunosuppressive treatment with cyclosporin A. This is the first case described in the setting of non-myeloablative preparation with fludarabine and melphalan and followed by donor leukocyte infusion (DLI) 2 and 4 months post allo-BMT. The influence of these factors on development of VZV virus infection is discussed. We also highlight the high incidence and high mortality in VZV infection in immunocompromised patients as well as the frequent atypical presentation.- - - - - - - - - - ranking = 4.8909505524996keywords = pain, abdominal pain (Clic here for more details about this article) |
16/141. Zoster paresis of the shoulder. Case report and review of the literature.More than 95% of people in the united states are infected with the varicella zoster virus at some time in life, and this infection usually is manifested as chicken pox during childhood. The virus then establishes a latent infection of sensory ganglia, from which it may reactivate many years later to cause herpes zoster (shingles), a cutaneous painful rash along a dermatomal distribution. Less commonly, the varicella zoster virus may result in myotomal motor weakness or paralysis in addition to a painful dermatomal rash. A case of unilateral left C5-C6 segmental paresis attributable to herpes zoster in an otherwise healthy individual and a current review of the literature are presented. A case of zoster paresis of the shoulder muscles is presented to remind the orthopaedic community that this diagnosis may be confused with other diagnoses, including rotator cuff tear, and should be considered in the differential diagnosis of shoulder pain and shoulder girdle muscle weakness.- - - - - - - - - - ranking = 2.2903322034177keywords = pain (Clic here for more details about this article) |
17/141. Rapid contamination of the environments with varicella-zoster virus dna from a patient with herpes zoster.patients with zoster are considered to be less contagious than varicella patients because their infection is localised. It is not known, however, when and for how long a spread of varicella-zoster virus (VZV) from a zoster patient begins and continues and the extent of virus spread from the patient. The polymerase chain reaction (PCR) was used to detect VZV dna in samples obtained from the hands and throat of a patient with zoster and from her room environments including surfaces of the back of a chair, the door handle, the table and the air conditioner filter. VZV dna was detected on the surfaces of the back of the seat and the table and in peripheral blood mononuclear cells (PBMCs) and serum on Day 4 of the illness. VZV DNAemia persisted for 4 days until Day 7 of the illness. It was also detected in samples collected from throat and the air conditioner filter on Days 6 and 7 of the illness respectively. All of the surfaces, that were examined in her home environment, were contaminated with VZV dna by Day 7 of the illness. The present study showed rapid and wide spread of VZV dna in the environment even from a patient with zoster.- - - - - - - - - - ranking = 0.012825414757294keywords = back (Clic here for more details about this article) |
18/141. Pseudo-myocardial infarction during an episode of herpes zoster.The patient arrived at the emergency unit with a history of acute myocardial infarction, for which she was treated. Without improvement in the pain, the patient developed heart failure and underwent a hemodynamic study, which showed normal coronary arteries and extensive ventricular impairment. During evolution, the clinical findings improved and herpes zoster appeared on the right shoulder. In a few months the clinical findings subsided, and the findings of the electrocardiogram, chest X-ray, and ventricular function were normal. The patient is currently asymptomatic.- - - - - - - - - - ranking = 0.78206453346629keywords = pain, chest (Clic here for more details about this article) |
19/141. herpes zoster of the maxillary branch of the trigeminus nerve. Virological and serological studies.A 70-year-old male had erythematous and vesiculous lesions in the area of the right maxillary branch of the trigeminus nerve and was clinically diagnosed as having herpes zoster; virological and serological investigations of this case were carried out. Consequently, an electron microscopic observation revealed a great number of virus particles of herpes type in the vesiculous lesion and in baby hamster kidney BHK21/WI-21 cells, cultured after inoculating the fluid from the vesicle formed on the patient's upper lip or from serum harvested during the viremia. When BHK21/WI-21 cells infected with this virus were tested for antigenicity by an indirect immunofluorescent staining technique, they showed a positive staining to antivaricella-zoster virus. When serum of this patient was assayed fof the antibody level against varicella-zoster virus by the complement fixation test at various time intervals during the therapeutic period, this antibody titer on recovery period showed a threefold increase in comparison to that at onset. From these findings, this infectious disease was precisely diagnosed as herpes zoster.- - - - - - - - - - ranking = 0.0031894238396848keywords = upper (Clic here for more details about this article) |
20/141. Varicella zoster meningitis preceeded by thrombophlebitis in a patient with Hodgkin's disease.Varicella zoster (V-Z) infections are common among patients with hematological malignancies, particularly Hodgkin's disease (HD). The common denominator in both HD and V-Z infections is immunosuppression. Most of V-Z infections occur in patients with HD during the remission period, who have mixed cellularity sub-type, with stage III disease and who have received combined chemo-radiation therapy. Involvement of the central nervous system usually manifests as post-herpetic neuralgia or encephalitis. Angiitis has also been found in association with V-Z infections. The authors describe a case of HD who developed V-Z meningitis preceeded by superficial thrombophlebitis of upper extremities during the period of active chemotherapy.- - - - - - - - - - ranking = 0.0031894238396848keywords = upper (Clic here for more details about this article) |
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