A CASE REPORT: HERPES ZOSTER WITH SACRAL INVOLVEMENT

Yıl 2020, Cilt: 2 Sayı: 1, 159 - 160, 26.04.2020

Muhammed Ekmekyapar Tuba Ekmekyapar Hakan Oğuztürk Şükrü Gürbüz Hasan Gökçe

Öz

Introduction: The Varicella Zoster Virus (VZV) is a member of the herpes virus family. It is usually characterized with neuralgia which is accompanied by painful vesicles that involve one side or more than one neighboring dermatome regions.
Case: The 77-year-old male patient visited the emergency service with the complaint of pain in the right gluteal region that had been going on for the last 2 days. The physical examination of the patient revealed diffuse vesicular-pustular lesions in the right sacral (gluteal) region. The treatment of the patient was started by the department of dermatology with valaciclovir, and the patient was discharged with recommendations.
Discussion: Studies that have been carried out so far on HZ showed that the probability of having HZ increases noticeably by aging. While virus-specific cellular immunity has a very important place in controlling viral activation and dissemination, VZV infections may progress more severely in patients with weakened immune systems. According to other studies in the literature, the most frequently involved region is the thoracic region, while it is followed by the cervical, lumbar and sacral regions. As a result of antiviral treatments, reduction was observed in HZ rashes and severity of pain. Acyclovir, valaciclovir, brivudine and famciclovir are drugs that may be used in treatment of HZ infections, while the effects and safety of these drugs are similar.
Conclusion: As a consequence, it should be kept mind that HZ, which develops in geriatric patients and individuals with weaker immune systems, may also appear with sacral region involvement, which is rarer, in addition to its typical regions of involvement.

Anahtar Kelimeler

Sacral pain, varicella zoster

Kaynakça

• 1- Azap A, Kurt H. Varisella Zoster virüs infeksiyon¬ları, Ankara Üniversitesi Tıp Fakültesi Mecmuası 2001;54(4):357-70.
• 2- Cohen JI, Brunell PA, Straus SE, Krause PR. Recent advances in varicella zoster virüs infection, AnnInternMed1999;130(11):922-32. http://dx.doi.org/10.7326/0003-4819-130-11-199906010-00017 PMid:10375341
• 3- Dworkin RH, Johnson RW, Breuer J et al. Recommendations for the management of herpes zoster, ClinInfectDis2007;44(Suppl 1):S1-26. http://dx.doi.org/10.1086/510206 PMid:17143845
• 4- Insinga RP, Itzler RF, Pellissier JM, Saddier P, Nikas AA. The incidence of herpes zoster in a United States administrative database, J Gen Intern Med2005;20(8):748-53. http://dx.doi.org/10.1111/j.1525-1497.2005.0150.x PMid:16050886 PMCid:PMC1490195
• 5- Schmader K. Herpes zoster in older adults, ClinInfectDis2001;32(10):1481-6. http://dx.doi.org/10.1086/320169 PMid:11317250
• 6- Kurlan JG, Connelly BL, Lucky AW. Herpes zoster in the first year of life following postnatal exposureto varicella-zostervirus: four case reports and a review of infantile herpes zoster. ArchDermatol2004;140:1268-72. http://dx.doi.org/10.1001/archderm.140.10.1268
• 7- Henry M, Feeder J, Diane M. Herpes zoster in other ¬wise healthy children. Pediatr Infect Dis J 2004;23: 451-7. http://dx.doi.org/10.1097/01.inf.0000126901.88982.32
• 8- Sterling JC, Kurtz JB. Viral infections. In: Champion RH, Burton JL, Burns DA, Breathnach SM: Textbook of Dermatology. Vol 2. Oxford: Blackwell Science, 1998:995-1097.
• 9- Arvin AM: Varicella-zostervirus. Clin Microbiol Rev 1996;9:361-81.
• 10- Chang CM, Woo E, Yu YL, Huang CY, Chin D: Herpes zoster and its neurological complications. Postgrad Med J 1987;63:85-9.
• 11- Yavaşoğlu İ, Arslan E, Gök M, Kurna R. Erişkin zona: olgu serisi ve derleme, Uludağ Üniversitesi Tıp Fakültesi Derg2008;34(3):123-5.