#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Compounding complications in a 87 year old patient with herpes zoster


Authors: MUDr. Antonín Kratochvíl 1,2;  Prof. MUDr. Eva Topinková, CSc. 2;  MUDr. Hana Lacmanová 2
Authors‘ workplace: Léčebna dlouhodobě nemocných a 2. interní klinika 3. LF UK a FNKV Praha 1;  Geriatrická klinika 1. LF UK a VFN Praha 2
Published in: Geriatrie a Gerontologie 2019, 8, č. 1: 27-30
Category: Case Reports

Overview

The case report describes manifestation and course of herpes zoster disease diagnosed in a geriatric patient. The initial diagnosis showed herpes zoster infection involving mandibular branch of the trigeminal nerve with facial nerve palsy. Geriatric age increases the risk of developing the disease, as well the development of the postherpetic neuralgia. In old age the herpetic infection often indicates a serious systemic disease and further diagnostics are required. Initial symptomatology of the herpes zoster disease is not pathognomonic, and it can be mistaken for other symptoms of a different disease and even if it is eventually determined, the exact identification of the affected branch in the case of a cranial nerve infection may remain uncertain. Related complications documented in the case report were accompanied by chronic pain and reduced food intake leading to malnutrition and consequently to infectious complications and the patient´s fall. It can be assumed that the underlying patient’s disease led to reactivation of the herpes infection, but the subsequent clinical development was also modified by chronic lymphocytic leukaemia diagnosed ex post. Vaccination of geriatric patients against herpes zoster can be a significant contribution to improving the quality of life as is clear from our case report and can prevent many subsequent complications. For wider use it seems that vaccinating patients with recombinant vaccination is an optimal alternative for the future.

Keywords:

heres zoster – chronic pain – chronic lymphocytic leukemia (CLL) – vaccination


Sources

1. Výška O, Matějovská Kubešová H. Imunosenescence a infekční komplikace vyššího věku. Kardiol Rev Int Med 2018; 20(1): 41–43.

2. Smith JB, Fenske NA. Herpes zoster and internal malignancy. South Med J 1995; 88: 1089–1092.

3. Buntinx F, Wachana R, Bartholomeeusen S, et al. Is herpes zoster a marker for occult or subsequent malignancy? Br J Gen Pract 2005;55(511): 102–107.

4. Sørensen HT, Olsen JH, Jepsen P, et al. The risk and prognosis of cancer after hospitalisation for herpeszoster: a population-based follow-up study. British Journal of Cancer (2004); 91(7): 1275–1279.

5. Anderson LA, Landgren O, Engels EA. Common community acquired infections and subsequent risk of chronic lymphocytic leukaemia. Br J Haematol 2009; 147: 444–449.

6. Landgren O, Gridley G, Check D, et al. Acquired immune-related and inflammatory conditions and subsequent chronic lymphocytic leukaemia. Br J Haematol 2007; 139: 791–798.

7. Růžičková Jarešová L. Herpes zoster, komplikace a postherpetické neuralgie, prevence. Dermatol praxi 2014; 8(4): 152–153.

8. Smetana J, Salavec M, Boštíková V, et al. Herpes zoster v České republice – epidemiologie a klinické projevy. Epidemiol Mikrobiol Imunol 2010; 59(3): 138–146.

9. Hayward AR, Herberger M. Lymphocyte responses to varicella zoster virus in the elderly. J Clin Immunol 1987; 7: 177–178.

10. Cohen JI. Herpes zoster. N Engl J Med 2013; 369: 255–263.

11. Ambler Z. Periferní paréza nervus facialis. Interní Med 2010; 12(9): 445–447.

12. www.sukl.cz

13. Michael S, Simberkof MD, Robert D, et al. Safety of Herpes Zoster Vaccine in the Shingles Prevention Study: A Randomized Trial. Ann Intern Med 2010; 52(9): 545–554.

14. https://www.ema.europa.eu/documents/product-information/shingrix-epar-product-information_cs.pd

Labels
Geriatrics General practitioner for adults Orthopaedic prosthetics
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#