Disseminated zoster in an elderly patient.
A 97-year-old lady was hospitalized for left leg cellulitis. Comorbidity included hypertension and congestive heart failure. While in hospital, she developed a painless vesicular rash localized to the territory of the left trigeminal nerve (third branch), which evolved to pustules and crusts (Figure 1). A chickenpox-like disseminated eruption of vesicles followed within 4 days, with the same evolution pattern (Figure 2).The diagnosis of disseminated zoster was suspected. A PCR analysis confirmed the presence of varicella-zoster-virus (VZV) in an abdominal vesicle. The patient was treated with oral valacyclovir for 7 days. Clinical examination, laboratory tests (including HIV serology), and a chest radiograph revealed no evidence of underlying immunodeficiency or malignancy.
Capron
J
J
Internal Medicine Dept, Tenon Hospital, Paris University, France.
Steichen
O
O
D000212:Acyclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D001415:Back; D005145:Face; D005260:Female; D006333:Heart Failure / Q000150:complications; D006562:Herpes Zoster / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D006973:Hypertension / Q000150:complications; D016133:Polymerase Chain Reaction; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir