Z Cerny1. 1. Department of Infectious Diseases, Medical Faculty, Masaryk University, Brno, Czech Republic. zcerny@med.muni.cz
Abstract
BACKGROUND: Repeated eruptions of herpes zoster are frequently detected in immunocompromised patients, but rarely may occur also in immunocompetent persons. While detailed analyses of repeated manifestations of this disease in the literature are scarce, experience with a small group of affected persons is presented. AIMS OF THE STUDY: To search for the nature of herpes zoster relapses occurrence and to use it in treatment quality improvement. METHODS: Analysis and processing of clinical documentation of the first and repeated eruptions of herpes zoster in 12 patients. Study of sex and age, presence of accompanying diseases, duration of the interval from the first eruption to the relapse, localization, complications and relation to antiviral therapy. RESULTS: The interval between the first and repeated manifestation ranged from 1 week to 30 years. The male to female ratio was 10/2. In 3 patients the disease was accompanied by malignancy, in 3 by diabetes mellitus and in 1 by proved immunodeficiency. The most frequent eruption localization was intercostal space. In 6 patients the relapse was localized at the same site, in 6 of them at different. Early relapses in the same localization appeared in immunodeficient persons and also in persons after the first attack treatment with acyklovir. Primary manifestation was accompanied by complications in 42%, repeated in 92%. CONCLUSIONS: Early herpes zoster relapses following shortly after the primary attack treated with acyklovir should be considered as a manifestation of immunity disorder requiring immediate treatment with other antiviral drug. Late relapses can be treated with acyclovir. (Tab. 2, Fig. 2, Ref. 22.)
BACKGROUND: Repeated eruptions of herpes zoster are frequently detected in immunocompromised patients, but rarely may occur also in immunocompetent persons. While detailed analyses of repeated manifestations of this disease in the literature are scarce, experience with a small group of affected persons is presented. AIMS OF THE STUDY: To search for the nature of herpes zoster relapses occurrence and to use it in treatment quality improvement. METHODS: Analysis and processing of clinical documentation of the first and repeated eruptions of herpes zoster in 12 patients. Study of sex and age, presence of accompanying diseases, duration of the interval from the first eruption to the relapse, localization, complications and relation to antiviral therapy. RESULTS: The interval between the first and repeated manifestation ranged from 1 week to 30 years. The male to female ratio was 10/2. In 3 patients the disease was accompanied by malignancy, in 3 by diabetes mellitus and in 1 by proved immunodeficiency. The most frequent eruption localization was intercostal space. In 6 patients the relapse was localized at the same site, in 6 of them at different. Early relapses in the same localization appeared in immunodeficient persons and also in persons after the first attack treatment with acyklovir. Primary manifestation was accompanied by complications in 42%, repeated in 92%. CONCLUSIONS: Early herpes zoster relapses following shortly after the primary attack treated with acyklovir should be considered as a manifestation of immunity disorder requiring immediate treatment with other antiviral drug. Late relapses can be treated with acyclovir. (Tab. 2, Fig. 2, Ref. 22.)
Authors: Barbara P Yawn; Peter C Wollan; Marge J Kurland; Jennifer L St Sauver; Patricia Saddier Journal: Mayo Clin Proc Date: 2011-01-10 Impact factor: 7.616