title: Identification and characterization of 20 immunocompetent patients with simultaneous varicella zoster and herpes simplex virus infection.
abstract: BACKGROUND
  It has been shown that varicella zoster virus (VZV) and herpes simplex virus (HSV) can co-localize to the same sensory ganglion. However, only a few case reports on VZV/HSV co-infections exist. Objective To identify and characterize patients with concurrent VZV and HSV infection at the same body site.
  
  
  METHODS
  In 1718 patients, the presence of VZV and HSV in suspicious skin lesions was investigated by polymerase chain reaction analysis. Clinical characteristics of co-infected patients were compared with matched control patients infected with either VZV or HSV. The data are discussed in the context of an extensive review of the literature.
  
  
  RESULTS
  Twenty (1.2%) of 1718 patients were infected with both VZV and HSV at the same body site. The mean age was 54 years (range, 2-83). The clinical diagnosis was zoster in 65%, herpes simplex in 20%, varicella in 10% and erythema multiforme in 5% of cases. The trigeminus region was affected in 60% and the trunk in 25%. Involvement of the head was most commonly associated with a severe course of disease and with older age.
  
  
  CONCLUSIONS
  Simultaneous VZV/HSV infection is rare but can occur in immunocompetent patients, which is often overlooked. The majority of cases is localized to the trigeminus region and affects elderly people.
authors.affiliation: Department of Dermatology, Ludwig-Maximilian University of Munich, Munich, Germany.
authors.forename: K A
authors.initials: KA
authors.lastname: Giehl
authors.forename: E
authors.initials: E
authors.lastname: Müller-Sander
authors.forename: M
authors.initials: M
authors.lastname: Rottenkolber
authors.forename: K
authors.initials: K
authors.lastname: Degitz
authors.forename: M
authors.initials: M
authors.lastname: Volkenandt
authors.forename: C
authors.initials: C
authors.lastname: Berking
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D002644:Chickenpox / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D017931:DNA Primers; D003937:Diagnosis, Differential; D005260:Female; D006562:Herpes Zoster / Q000150:complications* / Q000175:diagnosis; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000302:isolation & purification; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies
chemical_list: D017931:DNA Primers