播散性带状疱疹误诊为血管炎一例

Disseminated herpes zoster misdiagnosed as vasculitis: a case report

播散性带状疱疹较少见,主要见于老年人或体质较弱的个体,特别是免疫功能受抑制的人群。因该病少见,而且病情严重,可有发热等其他全身症状,因此早期容易出现误诊、误治。该文报道1例误诊为血管炎的患者,入院后结合其临床表现、组织病理检查及细胞学涂片,确诊为播散性带状疱疹。予抗病毒、营养神经、提高免疫力等治疗后好转出院。该例提示免疫功能受限的带状疱疹患者皮疹可以泛发且严重,易误诊为其他疾病。临床医师应提高对播散性带状疱疹的认识,关注早期皮损特点及患者免疫功能状态,完善相关检查,正确诊治播散性带状疱疹。

Disseminated herpes zoster is rarely encountered, mainly occurring in the elderly or individuals with poor physical conditions, especially in those with immunosuppression. It is a rare and severe disease that can cause fever and other systematic symptoms. It is likely to be misdiagnosed and improperly treated during the early stage. In this article, one case of disseminated herpes zoster misdiagnosed vasculitis was reported. After admission, clinical manifestations, histopathological examination and cytological smear test results were considered to confirm the diagnosis of disseminated herpes zoster. The patient was cured by antiviral, neurotrophic, and immunity enhancing therapies. This case suggests that the skin rash of herpes zoster patients with immunosuppression can be generalized and severe, and easily misdiagnosed as other diseases. Clinicians should deepen the understanding of disseminated herpes zoster, pay attention to the characteristics of early skin lesions and the immune function of patients and improve relevant examinations, thereby ensuring the accurate diagnosis and efficacious treatment of disseminated herpes zoster.