Zoster Sine Herpete: two unusual cases of varicella-zoster reactivation with atypical complaints of acute chest pain and severe headache.

Autor: Yang Y; Johns Hopkins University School of Medicine, Baltimore, MD, USA., Mahmood T; Biological Sciences, Florida International University, Miami, FL, USA., Siddiqui AH; Johns Hopkins Community Physicians, CIMS Hospitalist, Howard County General Hospital, Johns Hopkins Medicine, 5755 Cedar Lane, Columbia, MD, 21044, USA., Aziz MA; Johns Hopkins Community Physicians, CIMS Hospitalist, Howard County General Hospital, Johns Hopkins Medicine, 5755 Cedar Lane, Columbia, MD, 21044, USA. maziz7@jhmi.edu.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2023 Apr 18; Vol. 23 (1), pp. 239. Date of Electronic Publication: 2023 Apr 18.
DOI: 10.1186/s12879-023-08093-3
Abstrakt: In this case report, we describe two unusual presentations of varicella-zoster virus (VZV) reactivation without rash, a condition known as Zoster Sine Herpete (ZSH). In Case 1, a 58-year-old woman presented with severe right-sided chest pain under her breast that radiated to the ipsilateral back. After the initial workup ruled out cardiac and musculoskeletal etiologies, the characteristic dermatomal distribution of pain made us suspect VZV reactivation. A diagnosis of ZSH was made with positive VZV IgG and IgM serologies and symptomatic relief after famciclovir treatment. In Case 2, a 43-year-old woman presented with a severe headache and resolved sharp right flank pain. She was diagnosed with varicella meningitis after cerebrospinal fluid showed positive VZV DNA. Intravenous acyclovir treatment resulted in symptom resolution. The most common presentation of VZV reactivation is Herpes Zoster, or shingles, making ZSH a frequently missed diagnosis. High clinical suspicion is warranted to prevent life-threatening complications of ZSH.
(© 2023. The Author(s).)
Databáze: MEDLINE
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