Herpes Zoster Oftalmikus

Year 2012, Volume: 3 Issue: 3, 74 - 76, 01.07.2012

Mustafa Burak Sayhan Eylem Sezenler İsmail Hakkı Nalbur Gökçe Yağcı Esra Gezer

Abstract

Herpes zoster (HZ) acil servisin sık tanılarındandır. Ancak herpes
zoster oftalmikus (HZO) tipik olarak V1, V2 dermatomları boyunca
döküntü sonrası prodromal belirtilerle ortaya çıkan zonanın seyrek rastlanan bir formudur. Klasik olarak, HZO yaklaşık bir hafta
ateş, miyalji ve kırıklık gibi grip benzeri semptomlar ile başlar. Bu
vakada, sağ alın bölgesinde döküntü ve başağrısı şikayeti ile başvuran hastayı tanımladık. HZO, trigeminal sinirin oftalmik dalının
dağılımındaki varisella-zoster virüsünün (VZV) ciddi reaktivasyonudur. Herpes zoster oftalmikusun ayırıcı tanısı, başlangıcı ve
morbitidesinden dolayı acil hekimleri için önemlidir.

Keywords

Herpes zoster, oftalmikus, acil servis

Herpes Zoster Ophthalmicus

Abstract

Herpes zoster (HZ) is a common diagnosis in the emergency department, but herpes zoster ophthalmicus (HZO) is a rare form of shingles that typically presents with prodromal symptoms followed by a rash distributed along the V1-V2 dermatomes. Classically, HZO begins with flu-like symptoms including fever, myalgia and malaise for approximately one week. In the current case, we describe a woman who presented to our medical center with a headache and rash on the right forehead. HZO is a potentially serious reactivation of varicella-zoster virus (VZV) in the distribution of the ophthalmic division of the trigeminal nerve. The differential diagnosis of HZO is an important task for emergency physicians because of its rapid onset and severity

Keywords

Herpes zoster, ophthalmicus, emergency department

References

• Delengocky T, Bui CM. Complete ophthalmoplegia with pupillary in- volvement as an initial clinical presentation of herpes zoster ophthal- micus. J Am Osteopath Assoc 2008; 108: 615-21.
• Soyuncu S, Berk Y, Eken C, Gulen B, Oktay C. Herpes zoster as a useful cli- nical marker of underlying cell-mediated immune disorders. Ann Acad Med Singapore 2009; 38: 136-8.
• Whitley RJ. A 70-year-old woman with shingles: review of herpes zoster. JAMA 2009; 302: 73-80. [CrossRef]
• Bleibel W, Yi C, Bleibel H, D’Silvia KJ, Hemady N. Extraocular Myositis Pre- ceding Herpes. Zoster Ophthalmicus. Hospital physician 2006;3:47-50.
• Catron T, Hern HG. Herpes zoster ophthalmicus. West J Emerg Med 2008; 9: 174-6.
• Liesegang TJ. Herpes zoster ophthalmicus natural history, risk factors, clinical presentation, and morbidity. Ophthalmology 2008; 115: 3-12. [CrossRef]
• Shaikh S, Ta CN. Evaluation and management of herpes zoster ophthal- micus. Am Fam Physician 2002; 66: 1723-30.
• Gnann JW Jr. Varicella-zoster virus: atypical presentations and unusual complications. J Infect Dis. 2002; 186: 91-8. [CrossRef]
• Park KC, Yoon SS, Yoon JE, Rhee HY. A case of herpes zoster ophthal- micus with isolated trochlear nerve involvement. J Clin Neurol 2011; 7: 47-9. [CrossRef]
• Zingale LC, Beltrami L, Zanichelli A, Maggioni L, Pappalardo E, Cicardi B, et al. Angioedema without urticaria: a large clinical survey. CMAJ 2006; 175: 1065-70. [CrossRef]
• Papier A, Tuttle DJ, Mahar TJ. Differential diagnosis of the swollen red eyelid. Am Fam Physician 2007; 76: 1815-24.
• Johnson RW, Bouhassira D, Kassianos G, Leplège A, Schmader KE, We- inke T. The impact of herpes zoster and post-herpetic neuralgia on quality-of-life. BMC Med 2010; 8: 1741-5. [CrossRef]
• Opstelten W, Eekhof J, Neven AK, Verheij T. Treatment of herpes zoster. Can Fam Physician 2008; 54: 373-7.
• Drolet M, Brisson M, Schmader KE, Levin MJ, Johnson R, Oxman MN, et al. The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: a prospective study. CMAJ 2010; 182: 1731-6. [CrossRef]