title: Herpes zoster--varicella complicating anterior thoracic surgery: 2 case reports.
abstract: This article reviews the reactivation of the latent varicella-zoster virus infection within the sensory dorsal root ganglia resulting in shingles. Although the association between surgery and reactivation of the varicella-zoster virus is known, we feel it is important to keep the diagnosis of shingles in mind especially in a patient with sudden onset of increased pain after surgery. Our purpose is to report 2 rare clinical presentations of shingles after spinal surgery in which the patient's initial diagnosis was not clear until the classical rash was observed. Two case reports are presented in which 1 patient developed shingles 5 days after surgery with distribution of the maculopapular rash in a surgical incision, whereas the second patient did not present until 4 weeks after surgery with a disseminated picture. Early recognition of this postoperative problem is imperative for prompt and appropriate management, as misdiagnosis can lead to short-term and long-term pain control issues, postherpetic neuralgia, neuropathic pain, or other related sequelae.
authors.affiliation: University of Cincinnati College of Nursing, Cincinnati, OH, USA.
authors.forename: Elisha K
authors.initials: EK
authors.lastname: Godfrey
authors.forename: Christopher
authors.initials: C
authors.lastname: Brown
authors.forename: Jeffery L
authors.initials: JL
authors.lastname: Stambough
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006562:Herpes Zoster / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000601:surgery*