title: Herpes Zoster Induced Osteomyelitis in the Immunocompromised Patients: A 10-year Multicenter Study.
abstract: BACKGROUND
  Alveolar bone necrosis induced by Herpes zoster infection is considered as a rare manifestation of osteomyelitis and few case reports are presented in the literature.
  
  
  OBJECTIVE
  The aim of this study was to evaluate mandibular osteomyelitis caused by herpes zoster in the immunocompromised patients with histopathologically documented osteomyelitis in the mandible and herpes zoster infection.
  
  
  METHODS
  30 patients were recruited in this cross-sectional study. 19 patients were completely edentulous, 4 patients were partially edentulous and 7 with complete dentition. In all cases, specimens were analyzed using a conventional polymerase chain reaction (PCR) test for varicella zoster virus.
  
  
  RESULTS
  16 patients underwent dialysis, 9 patients received chemotherapy treatments and 5 patients had transplantation (four kidneys and one liver). Histopathological assessment demonstrated a nonspecific bone necrosis exhibiting an eosinophilic, homogeneous non-vital bone tissue with peripheral resorption surrounded by reactive connective tissue. PCR test was positive in 21 cases.
  
  
  CONCLUSIONS
  This study demonstrated that the frequency of osteomyelitis induced by herpes zoster could be more than the records provided by previous studies. Histopathological findings might be nonspecific in such patients. PCR test was not positive for all HZ induced osteomyelitis patients.
authors.affiliation: Dept. of Craniomaxillofacial Surgery, School of Dentistry, Shiraz University of Medical Science, Shiraz, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Tabrizi
authors.affiliation: Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Science, Shiraz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Dehghani Nazhvani
authors.affiliation: Dept. of Pathology, Tabriz University of Medical Science,Tabriz, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Vahedi
authors.affiliation: Dept. of Maxillofacial Surgery, Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Gholami
authors.affiliation: Postgraduate Student of Oral and Maxillofacial Pathology, Shiraz University of Medical Science, Shiraz, Iran.
authors.forename: Raziyeh
authors.initials: R
authors.lastname: Zare
authors.affiliation: Postgraduate Student of Oral and Maxillofacial Pathology, Shiraz University of Medical Science, Shiraz, Iran.
authors.forename: Raha
authors.initials: R
authors.lastname: Etemadi Parsa
keywords: Herpes zoster; Mandible; Osteomyelitis; Zona