title: [Case of zoster sine herpete presenting with dysphagia diagnosed by PCR analysis of VZV DNA in auricular skin exudates].
abstract: A 66-year-old woman was admitted to our hospital because of hoarseness and dysphagia after right earache and pharyngalgia. She showed right glossopharyngeal nerve and vagus nerve palsies, but no other neurological deficits. There was no skin rash within the regions of her ear, oral cavity, pharynx and larynx. Slight increase of mononuclear cells was noted in the cerebrospinal fluid. MR brain imaging was normal. We diagnosed her as zoster sine herpete (ZSH) and treated her with acyclovir, after which she almost completely recovered. The examination of antibodies and DNA of varicella zoster virus (VZV) in the serum and cerebrospinal fluid revealed a pattern of previous zoster infection without evidences of reactivation. However, VZV DNA was detected in auricular skin exudates with PCR. We conclude that PCR analysis of VZV DNA in auricular skin exudates can be a useful diagnostic tool for the diagnosis of zoster sine herpete presenting with painful glossopharyngeal nerve and vagus nerve palsies.
authors.affiliation: Department of Neurology, The Jikei University Kashiwa Hospital.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yaguchi
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hisatomi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sekine
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Matsui
authors.forename: Mariko
authors.initials: M
authors.lastname: Nagatomo
authors.forename: Kiyoharu
authors.initials: K
authors.lastname: Inoue
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000032:analysis*; D003680:Deglutition Disorders / Q000209:etiology*; D004423:Ear; D004433:Earache / Q000209:etiology; D005122:Exudates and Transudates / Q000737:chemistry*; D005260:Female; D020435:Glossopharyngeal Nerve Diseases / Q000209:etiology; D014645:Herpesvirus 3, Human / Q000235:genetics*; D006801:Humans; D016133:Polymerase Chain Reaction; D012867:Skin; D016896:Treatment Outcome; D031368:Zoster Sine Herpete / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000212:Acyclovir