Herpes Zoster Ophthalmicus In An Immunocompetent Elderly Patient: Case Report

Year 2019, Volume: 3 Issue: 2, 61 - 65, 31.08.2019

Sevil Alkan Çeviker , Özgür Günal , Süleyman Sırrı Kılıç Eda Köksal , Cemanur Aygün

Abstract

Herpes zoster infections are more common in immunosuppressive  individuals and those over 45 years of age. 10-20% of all Herpes zoster cases are Herpes Zoster Ophthalmicus cases. Herpes Zoster Ophthalmicus is reported to be one of the major causes of blindness. Our patient with herpes zoster ophthalmicus is a patient with advanced age as a risk factor without known immunosuppression and this is very rare. In this case report, we aimed to emphasize that early diagnosis of Herpes Zoster Ophthalmicus disease and systemic antiviral treatment in addition to topical treatment can prevent permanent visual loss

Keywords

Herpes Zoster, Herpes Zoster Oftalmikus, immunocompetent elderly patient.

İmmunkompetan Yaşlı Hastada Gelişen Herpes Zoster Oftalmikus: Olgu Sunumu

Abstract

Herpes zoster enfeksiyonları, immunsupresif bireyler ile 45 yaş üstündekilerde daha sık görülür. Tüm Herpes zoster vakalarının %10-20’sini Herpes Zoster Oftalmikus vakaları oluşturur. Herpes Zoster Oftalmikus’un körlüğün önemli nedenlerinden biri olduğu bildirilmektedir. Herpes Zoster Oftalmikus tanılı olgumuz, bilinen immunsupresyonu olmayan risk faktörü olarak sadece ileri yaşı olan hasta olup, bu durum oldukça nadir görülmektedir.  Sunulan bu olgu ile; Herpes Zoster Oftalmikus hastalığının erken tanısı ve topikal tedaviye ilaveten  sistemik antiviral tedavi ile kalıcı görme kaybını önlenebileceğini vurgulamayı amaçladık.

Keywords

Herpes Zoster, Herpes Zoster Oftalmikus, İmmunkompetan yaşlı hasta.

References

• 1. Topçu W. A., Söyletir G. ve Doğanay M. Enfeksiyon Hastalıkları ve Mikrobiyolojisi. 4.baskı. Nobel Tıp Kitabevleri. 2017: 1474-1478.
• 2. Liesegang TJ. Herpes zoster ophthalmicus natural history, risk factors, clinical presentation, and morbidity. Ophthalmology. 2008; 115: 3–12.
• 3. Marra F., Chong M. and Najafzadeh M. Increasing incidence associated with herpes zoster infection in British Columbia, Canada. BMC Infect Dis. 2016; 16: 589.
• 4. Schmader K. Herpes zoster. Clin Geriatr Med. 2016; 32: 539–353.
• 5. Marin M., et al. Risk factors for herpes zoster among adults. Open Forum Infect Dis. 2016; 3:119.
• 6. Kwok TSH., Daneman N., and Lake SL. Headache and vision changes in an elderly man with rheumatoid arthritis. Int J Rheum Dis. 2019;22(7):1331-1334.
• 7. Arvin A. Aging, immunity and the varicella zoster virus. NEJM. 2005; 352: 2266-7.
• 8. Thomas SL. and Hall AJ. What does epidemiology tell us about risk factors for herpes zoster? Lancet Infect Dis. 2004; 4: 26-33.
• 9. Vrcek I., Choudhury E. and Durairaj V. Herpes Zoster Ophthalmicus: A Review for the Internist. Am J Med. 2017;130(1):21–26.
• 10. Hutchinson J. A clinical report on herpes zoster ophthalmicus (shingles affecting the forehead and nose). Trans Am Ophthalmol Soc. 1942; 40:390- 439.
• 11. Sjaastad O. et al. Shortlasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating, and rhinorrhea. Cephalalgia 1989; 9:147–156.
• 12. Akpinar ÇK. ve ark. Herpes Zoster Ophthalmicus That Mimics the SUNCT Syndrome. Noro Psikiyatr Ars. 2016; 53(2):184-185.
• 13. Sengupta, S. Cutaneous herpes zoster. Curr Infect Dis Rep. 2013; 15: 432–439.
• 14. Woznowski M. et al. Fulminant staphylococcus lugdunensis septicaemia following a pelvic varicella-zoster virus infection in an immune- deficient patient: a case report. Eur J Med Res. 2010; 15: 410–414.
• 15. Sanjay S. et all. Complete unilateral ophthalmoplegia in herpes zoster ophthalmicus. J Neuroophthalmol. 2009; 29(4): 325-337.
• 16. Werner RN, et al. European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 2: Treatment. J Eur Acad Dermatol Venereol. 2017;31(1):20-29.
• 17. Tran KD., et al. Epidemiology of herpes zoster ophthalmicus: recurrence and chronicity. Ophthalmology. 2016; 123: 1469–1475.
• 18. Hales, C.M., et al. Update on recommendations for use of herpes zoster vaccine. MMWR Morb Mortal Wkly Rep. 2014; 63: 729–731.