Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent Patients
BACKGROUND: Herpes Zoster occurs due to reactivation of the varicella zoster virus (VZV). It mainly affects patients with suppressed cell-mediated immunity, however, there have been cases reported in immunocompetent patients. THE CASES: Case 1: A 26-year-old male presented with severe headache in...
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University Library System, University of Pittsburgh
2025-01-01
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| Series: | International Journal of Medical Students |
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| Online Access: | http://ijms.info/IJMS/article/view/2979 |
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| author | Vanessa Jarelly Rodríguez-Huerta Mauricio Alejandro Saldaña Ruiz Vanessa Pamela Salolin-Vargas Jessica Edith Acevedo Rodriguez Leopoldo David Trujillo-García |
| author_facet | Vanessa Jarelly Rodríguez-Huerta Mauricio Alejandro Saldaña Ruiz Vanessa Pamela Salolin-Vargas Jessica Edith Acevedo Rodriguez Leopoldo David Trujillo-García |
| author_sort | Vanessa Jarelly Rodríguez-Huerta |
| collection | DOAJ |
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BACKGROUND: Herpes Zoster occurs due to reactivation of the varicella zoster virus (VZV). It mainly affects patients with suppressed cell-mediated immunity, however, there have been cases reported in immunocompetent patients.
THE CASES: Case 1: A 26-year-old male presented with severe headache in the frontal region on his right side, nausea and dizziness. Analgesic treatment with oral Diclofenac every 12 hours at unspecified dose was indicated. Three days later she returned with vesicles with erythematous base in the course of the ophthalmic trigeminal branch (Figure 1). The patient referred varicella at 6 years of age. Treatment was started with 1 tablet of Acyclovir 400 mg per oral (PO) every 6 hours for 8 days, Diclofenac Complex B intramuscularly (IM) at a dose of 1 ampoule every 24 hours for six days and sublingual ketorolac every 24 hours for eight days. Case 2: A 19-year-old woman with erythematous lesions with vesicular lesions in the abdominal region. She reported a history of chickenpox at 3 years of age. Treatment with 1 tablet of Acyclovir 400 mg PO every 6 hours for 8 days, B complex with Diclofenac IM every 24 hours for six days and ketorolac sublingual every 24 hours. Case 3: A 56-year-old male with erythematous lesions and papules on the neck with mild pain and a history of chickenpox in childhood, without the presence of any immunosuppressive symptoms. She started treatment with oral acyclovir 400 mg every 8 hours PO for 7 days and diclofenac every 12 hours PO. All three patients presented at the follow-up visit with disappearance of all skin lesions, and without any complication.
CONCLUSION: All patients had an atypical presentation, secondary to the lack of a history of immunosuppression. Although advanced age is one of the most important risk factors, the three patients did not meet this factor. There are few cases of immunocompetent patients reported in the literature, which were treated mainly with Acyclovir, as used in our patients, obtaining a positive response. This type of presentation is important for medical literature, mainly because it is not considered as differential diagnosis, therefore it is important to consider it due to the recent cases reported in the last years.
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| format | Article |
| id | doaj-art-dcf95ac7e2c242c480078f618ebfe14f |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | University Library System, University of Pittsburgh |
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| series | International Journal of Medical Students |
| spelling | doaj-art-dcf95ac7e2c242c480078f618ebfe14f2025-01-01T13:37:40ZengUniversity Library System, University of PittsburghInternational Journal of Medical Students2076-63272025-01-0112Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent PatientsVanessa Jarelly Rodríguez-Huerta0Mauricio Alejandro Saldaña Ruiz1Vanessa Pamela Salolin-Vargas2Jessica Edith Acevedo Rodriguez3Leopoldo David Trujillo-García4Benemérita Universidad Autónoma de Puebla, Puebla, México.Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, México.Universidad WesthillTecnológico de Monterrey, Zapopan, México.Universidad Nacional Autónoma de México, Ciudad de México, México. BACKGROUND: Herpes Zoster occurs due to reactivation of the varicella zoster virus (VZV). It mainly affects patients with suppressed cell-mediated immunity, however, there have been cases reported in immunocompetent patients. THE CASES: Case 1: A 26-year-old male presented with severe headache in the frontal region on his right side, nausea and dizziness. Analgesic treatment with oral Diclofenac every 12 hours at unspecified dose was indicated. Three days later she returned with vesicles with erythematous base in the course of the ophthalmic trigeminal branch (Figure 1). The patient referred varicella at 6 years of age. Treatment was started with 1 tablet of Acyclovir 400 mg per oral (PO) every 6 hours for 8 days, Diclofenac Complex B intramuscularly (IM) at a dose of 1 ampoule every 24 hours for six days and sublingual ketorolac every 24 hours for eight days. Case 2: A 19-year-old woman with erythematous lesions with vesicular lesions in the abdominal region. She reported a history of chickenpox at 3 years of age. Treatment with 1 tablet of Acyclovir 400 mg PO every 6 hours for 8 days, B complex with Diclofenac IM every 24 hours for six days and ketorolac sublingual every 24 hours. Case 3: A 56-year-old male with erythematous lesions and papules on the neck with mild pain and a history of chickenpox in childhood, without the presence of any immunosuppressive symptoms. She started treatment with oral acyclovir 400 mg every 8 hours PO for 7 days and diclofenac every 12 hours PO. All three patients presented at the follow-up visit with disappearance of all skin lesions, and without any complication. CONCLUSION: All patients had an atypical presentation, secondary to the lack of a history of immunosuppression. Although advanced age is one of the most important risk factors, the three patients did not meet this factor. There are few cases of immunocompetent patients reported in the literature, which were treated mainly with Acyclovir, as used in our patients, obtaining a positive response. This type of presentation is important for medical literature, mainly because it is not considered as differential diagnosis, therefore it is important to consider it due to the recent cases reported in the last years. http://ijms.info/IJMS/article/view/2979Herpes ZosterAcyclovirCase Report |
| spellingShingle | Vanessa Jarelly Rodríguez-Huerta Mauricio Alejandro Saldaña Ruiz Vanessa Pamela Salolin-Vargas Jessica Edith Acevedo Rodriguez Leopoldo David Trujillo-García Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent Patients International Journal of Medical Students Herpes Zoster Acyclovir Case Report |
| title | Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent Patients |
| title_full | Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent Patients |
| title_fullStr | Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent Patients |
| title_full_unstemmed | Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent Patients |
| title_short | Uncommon Presentation: Simultaneous Herpes Zoster Infection in Immunocompetent Patients |
| title_sort | uncommon presentation simultaneous herpes zoster infection in immunocompetent patients |
| topic | Herpes Zoster Acyclovir Case Report |
| url | http://ijms.info/IJMS/article/view/2979 |
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