Neurological Complications of Herpes Zoster – a Case Report

Czech version

Authors: R. Chlíbek ¹; J. Smetana ¹; V. Boštíková ¹; P. Kosina ²; P. Prášil ²; M. Salavec ³; P. Rejtar ⁴; P. Boštík ⁵
Authors‘ workplace: Katedra epidemiologie, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové ¹; Klinika infekčních nemocí LF UK a FN Hradec Králové ²; Katedra dermatovenerologie LF UK a FN Hradec Králové ³; Radiologická klinika LF UK a FN Hradec Králové ⁴; Centrum pokročilých studií, Fakulta vojenského zdravotnictví Univerzity obrany, Hradec Králové ⁵
Published in: Cesk Slov Neurol N 2011; 74/107(4): 486-489
Category: Case Report

Overview

Herpes zoster (HZ) is not a rare disease – the average annual incidence in Czech Republic only was 6,306 cases (61,3 per 100 thousand inhabitants) during the period 1990–2008. The peak incidence age group is between 60–70 years, however the risk for the disease increases steadily after 50 years of age and so does the likelihood for the development of complications.The most common complications reported in Czech Republic during the year 2008 were those affecting central nervous system (CNS), such as meningitis, encephalitis and other diseases of CNS (30, 21 and 20 cases, respectively), followed by ocular involvement (94 cases) and generalized herpes zoster (13 cases). Immunosuppression increases the risk of the development of disease, the severity of attack and the likelihood of complications. Here we present a case report of herpes zoster in a patient with several co-morbidities, who developed neurological complications.The case report contains a review of basic epidemiological and clinical characteristics of HZ, as well as common complications of this disease, and a summary of the epidemiological situation in Czech Republic.

Key words:
herpes zoster – neurological complications – varicella-zoster virus – epidemiology

Sources

1. Loparev VN, Rubtcova EN, Bostik V, Tzaneva V, Sauerbrei A, Robo A et al. Distribution of varicella-zoster virus (VZV) wild-type genotypes in northern and southern Europe: evidence for high conservation of circulating genotypes. Virology 2009; 383(2): 216–225.

2. Opstelten W, Van Essen GA, Schellevis F, Verheij TJ, Moons KG. Gender as an independent risk factor for herpes zoster: a population-based prospective. Ann Epidemiol 2006; 16(9): 692–695.

3. Gabutti G, Rota MC, Guido M, De Donno A, Bella A, Ciofi degli Atti ML et al. The epidemiology of Varicella Zoster Virus infection in Italy. BMC Public Health 2008; 8: 372.

4. Roubalová K, Seman J. Sérologický přehled protilátek proti herpetickým virům CMV, BV, VZV. Zprávy CEM 1998; 7, příloha 1: 29–31.

5. Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster? Lancet Inf Dis 2004; 4(1): 26–33.

6. Chapman RS, Cross KW, Fleming DM. The incidence of shingles and its implications for vaccination policy. Vaccine 2003; 21(19–20): 2541–2547.

7. Weinberg JM. Herpes zoster: Epidemiology, natural history, and common complications. J Am Acad Dermatol 2007; 57 (Suppl 6): S130–S135.

8. Sampathkumar P, Drage LA, Martin DP. Herpes Zoster (Shingles) and Postherpetic Neuralgia. Mayo Clin Proc 2009; 84(3): 274–80.

9. Johnson RW, Whitton TL. Management of herpes zoster (shingles) and postherpetic neuralgia. Expert Opin Pharmacother 2004; 5(3): 551–559.

10. Wood MJ, Kay R, Dworkin RH, Soong SJ, Whitley RJ. Oral acyclovir therapy accelerates pain resolution in patients with Herpes zoster: a meta-analysis of placebo-controlled trials. Clin Infect Dis 1996; 22(2): 341–347.

11. Sanford M, Keating GM. Zoster vaccine (Zostavax): a review of its use in preventing herpes zoster and postherpetic neuralgia in older adults. Drugs Aging 2010; 27(2): 159–176.