[Ramsay Hunt syndrome associated with eosinophilic pneumonia].
A 66-year-old woman was admitted to the hospital because of dry coughing. Ten days before admission, the patient had suffered from facial palsy accompanying otic zoster infection (Ramsay Hunt syndrome). Acyclovir was given, and during the two weeks after admission, the facial palsy resolved completely. The dry coughing worsened, and marked eosinophilia developed (1.930/mm3). A chest roentgenogram and a computed tomogram revealed wandering non-segmental infiltration in the left lung field. Examination of a specimen obtained by transbronchial lung biopsy revealed moderate eosinophilic infiltration into thickened alveolar septa and alveolar spaces. An elevated CD 4/CD 8 ratio (4.12) and a high level of eosinophilic cationic protein (8.730 micrograms/l) were found in bronchoalveolar lavage fluid. Eosinophilic pneumonia was diagnosed. The patients condition improved without medication within one month after the onset of the dry coughing. Laboratory results revealed no parasitic or mycotic infection, and both an acyclovir skin test and a lymphocyte stimulation test were negative, which suggested that the pneumonia had been induced by an allergic reaction to unknown antigens resulting from Th 1/Th 2 imbalance after reactivation of varicella-zoster virus latent in sensory ganglia.
Kodama
K
K
Department of Internal Medicine, Minamitane Town Hospital, Kagoshima, Japan.
D000368:Aged; D016516:CD4-CD8 Ratio; D005260:Female; D016697:Herpes Zoster Oticus / Q000150:complications*; D014645:Herpesvirus 3, Human / Q000502:physiology; D006801:Humans; D011657:Pulmonary Eosinophilia / Q000175:diagnosis / Q000209:etiology*; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D017735:Virus Latency