Cough after laryngeal herpes zoster: a new aspect of post-herpetic sensory disturbance.
OBJECTIVE
Although neurogenic cough is increasingly recognised, its pathophysiology remains obscure. We describe two cases of chronic cough following laryngeal herpes zoster, a rarely described manifestation of varicella-zoster virus reactivation, and suggest that this may be analogous to post-herpetic neuralgia. The same mechanisms may cause both phenomena.


METHODS
We describe two cases of chronic cough persisting for more than three months following an acute attack of laryngeal herpes zoster.


CONCLUSIONS
Neuronal damage by varicella-zoster virus results in irritable nociceptors and deafferentation, mechanisms known to cause post-herpetic neuralgia. When the vagus nerve is affected, as in laryngeal herpes zoster, the result may be a chronic cough. Similar damage may underlie chronic neurogenic cough in other contexts.
Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand.
B
B
Ling
ENT, Northern Clinical School, University of Sydney, NSW, Australia.
D
D
Novakovic
Department of Otolaryngology - Head and Neck Surgery, Weill Cornell Medical College, New York, New York, USA.
L
L
Sulica
D000368:Aged; D003371:Cough / Q000209:etiology*; D005260:Female; D006562:Herpes Zoster / Q000150:complications*; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications* / Q000821:virology; D008297:Male; D008875:Middle Aged; D020421:Vagus Nerve Diseases / Q000150:complications / Q000821:virology