Laryngeal paralysis due to generalized varicella virus infection – a case report

Czech version

Authors: Mahútová J. ^1,2; Večeřa J. ²; Hajtman A. ¹
Authors‘ workplace: Klinika otorinolaryngológie a chirurgie hlavy a krku JLF UK a UN Martin ¹; ORL oddelenie, FN Trenčín ²
Published in: Otorinolaryngol Foniatr, 71, 2022, No. 4, pp. 230-233.
Category: Case Reports
doi: https://doi.org/10.48095/ccorl2022230

Overview

The presence of herpetic infection in the larynx is rare. Herpes zoster is an acute viral disease caused by the varicella zoster virus. The zoster virus is the same as the varicella virus. Varicella is a primary infection of an unimmunized organism and remains in the body for life in the area of the posterior sensitive roots of the spinal ganglia. Reactivation of the virus or reinfection of an already immunized organism causes herpes zoster. Varicella zoster virus is included in the group of alphaviruses, its size is 150–200 nanometers. We present the case of a 67-year-old man with a history of throat pain, hoarseness, difficulty of swallowing, without the presence of skin effusion for several days. On objective examination found the paralysis of the left hemilaryngeus. On the 6th day, there was a generalized sowing of tiny vesicles on the body and a herpetic sowing on the mucosa of the oral cavity, pharynx and larynx. Infection with the varicella zoster virus has been confirmed serologically and by the PCR method from vesicles swabs. Despite complex therapy, the patient still has left hemilaryngeal paralysis after 3 months.

Keywords:

dysphagia – herpes zoster virus – laryngeal paralysis – aciclovir

Sources

1. Holečková K. Hepes zoster. In: Vademecum medici. 6. vyd. Martin: Osveta 2003: 1222–1223.

2. Kozub P, Šimaljaková M. Herpes zoster – aktuálne pohlady na liečbu. Via Pract 2008; 5 (10): 439–443.

3. Joo T, Lee YC, Kim TG. Herpes zoster involving the abducens and vagus nerves without typical skin rash: A case report and literature review. Medicine (Baltimore) 2019; 98 (19): e15619. Doi: 10.1097/MD.0000000000015619.

4. Park BS, Park HS, Lee HJ et al. A Case of Herpes Zoster Laryngitis with Isolated Vagus Nerve Paralysis. Korean J Otorhinolaryngol-Head Neck Surg 2010; 53 (10): 636–639. Doi: 10.3342/kjorl-hns.2010.53.10.636.

5. Zhang J, Wei X. Ramsay Hunt syndrome affecting the vagus nerve with epiglottic ulcers as the first manifestation: a case report. J Int Med Res 2020; 48 (9): 300060520952276. Doi: 10.1177/0300060520952276.

6. Lyngberg KK, Svensson BH. Herpes zoster paresis. A review of the literature and case reports. Ugeskr Laeger 1990; 152 (17): 1214–1217.

7. Fujiwara K, Furuta Y, Fukuda S. A Case of Associated Laryngeal Paralysis Caused by Varicella Zoster Virus without Eruption. Case Rep Med 2014; 2014: 916265. Doi: 10.1155/2014/916265.

8. Hudíková M, Dršata J. Paréza zvratného nervu. Neurol Praxi 2012; 13 (5): 259–260.