An unusual presentation of herpes zoster ophthalmicus: orbital myositis preceding vesicular eruption.
OBJECTIVE
To present a case of orbital myositis associated with herpes zoster ophthalmicus.


METHODS
Observational case report.


METHODS
A 47-year-old woman with acute retrobulbar eye pain and diplopia preceding the vesicular rash of herpes zoster ophthalmicus was evaluated and treated.


RESULTS
Magnetic resonance imaging showed enlargement and enhancement of extraocular muscles consistent with an inflammatory myopathy. Following acyclovir and prednisone treatment, all symptoms resolved, and neuralgia did not develop.


CONCLUSIONS
Herpes zoster may cause symptoms and signs of orbital myositis before eruption of cutaneous skin lesions and thus should be considered in the differential diagnosis of an acute orbital myositis.
Kawasaki
Aki
A
Department of Neuro-ophthalmology, Hôpital Ophthalmique Jules Gonin, Lausanne, Switzerland. aki-kawasaki@ophthal.vd.ch
Borruat
François-Xavier
FX
D000212:Acyclovir / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D004172:Diplopia / Q000175:diagnosis; D004359:Drug Therapy, Combination; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000473:pathology*; D016727:Orbital Pseudotumor / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010146:Pain / Q000150:complications; D011241:Prednisone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D011241:Prednisone; D000212:Acyclovir