Herpes zoster(HZ)is a painful condition resulting from reactivation of dormant varicella-zoster virus(VZV)in a previously VZV-infected person[1].Typical clinical manifestation of HZ are unilateral radicular pain and a...Herpes zoster(HZ)is a painful condition resulting from reactivation of dormant varicella-zoster virus(VZV)in a previously VZV-infected person[1].Typical clinical manifestation of HZ are unilateral radicular pain and a vesicular rash limited to one side of the body in the distribution of a nerve[2].The most common complication of HZ postherpetic neuralgia(PHN).展开更多
BACKGROUND Intestinal obstruction is a common occurrence in clinical practice.However,the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare.In the diagnostic...BACKGROUND Intestinal obstruction is a common occurrence in clinical practice.However,the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare.In the diagnostic and treatment process,clinicians consider it crucial to identify the primary causes of its occurrence to ensure effective treatment and avoiding misdiagnosis.CASE SUMMARY Herein,we present the case of a 40-year-old female patient with intestinal obstruction who underwent laparoscopic appendectomy and developed herpes zoster after surgery.Combining the patient's clinical manifestations and relevant laboratory tests,it was suggested that the varicella zoster virus reactivated during the latent period after abdominal surgery,causing herpes zoster.Subsequently,the herpes virus invaded the visceral nerve fibers,causing gastrointestinal dysfunction and loss of intestinal peristalsis,which eventually led to intestinal obstruction.The patient was successfully treated through conservative treatment and antiviral therapy and subsequently discharged from the hospital.CONCLUSION Pseudo-intestinal obstruction secondary to herpes zoster infection is difficult to distinguish from mechanical intestinal obstruction owing to various causes.In cases of inexplicable intestinal obstructions,considering the possibility of a viral infection is essential to minimize misdiagnosis and missed diagnoses。展开更多
BACKGROUND Herpes zoster is caused by reactivation of latent varicella-zoster virus infection within the sensory nerve ganglion of the spinal or cranial nerves.Laryngeal herpes zoster is rare and involves superior lar...BACKGROUND Herpes zoster is caused by reactivation of latent varicella-zoster virus infection within the sensory nerve ganglion of the spinal or cranial nerves.Laryngeal herpes zoster is rare and involves superior laryngeal nerve,which leads to several complications such as throat pain,and cough.CASE SUMMARY Patient concerns:A 52-year old woman presented with a 70 d history of throat pain and a 67 d history of non-productive cough.Three days after onset of pain,she was diagnosed with laryngeal herpes zoster.Flexible nasolaryngoscopy revealed multiple white ulcerated lesions on the left hemi epiglottis and the left supraglottic area.She was prescribed with 750 mg famciclovir a day for 7 d,and 150 mg pregabalin,100 mg tramadol and 10 mg nortriptyline a day for 67 d.However,despite of these medications,she complained of pain and persistent cough.Therefore,superior laryngeal nerve block under ultrasound guidance was performed.Three days after the intervention,the throat pain and cough disappeared.The patient remained symptom-free at 3 mo follow-up.CONCLUSION A superior laryngeal nerve block can be an effective option for treatment of pain and cough following laryngeal herpes zoster.展开更多
BACKGROUND Western medicine is beneficial for the recovery of neurological function in patients with depression,but some patients experience side effects such as headaches,dizziness,nausea,gastrointestinal symptoms,in...BACKGROUND Western medicine is beneficial for the recovery of neurological function in patients with depression,but some patients experience side effects such as headaches,dizziness,nausea,gastrointestinal symptoms,insomnia,and cardiac dysfunction.In recent years,integrative medicine has achieved positive results in the treatment of various diseases.AIM To study Chuanjin Qinggan decoction combined with selective serotonin reuptake inhibitors(SSRIs)in patients with herpes zoster complicated by depression.METHODS Patients with herpes zoster complicated by depression who were treated at the Yantai Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were retrospectively selected as research participants.Among them,43 patients with herpes zoster complicated by depression who received SSRI treatment between January and December 2021 were assigned to the Western medicine group,while those who received combined treatment of traditional Chinese and Western medicine between January and December 2022 were assigned to the combined group.Both groups were treated for eight weeks.The degree of pain,effect of herpes zoster treatment,degree of improvement in depressive symptoms,serum neurotransmitter levels,sleep quality,and occurrence of adverse reactions were compared between the two groups.RESULTS We found that after eight weeks of drug treatment,the two treatment schemes achieved differing efficacy.In further comparison,we found that,compared with patients treated with SSRIs alone,patients treated with Chuanjin Qinggan decoction combined with SSRIs showed more significant improvement in depression and a greater increase in dopamine and 5-hydroxytryptamine levels after treatment(P<0.05).Patients treated with Chuanjin Qinggan decoction combined with SSRIs also experienced lower pain,better treatment efficacy for herpes zoster,better sleep quality,and a lower incidence of adverse reactions compared to those treated with SSRIs alone(P<0.05).All minor adverse reactions occurring during treatment were resolved after symptomatic treatment.CONCLUSION The treatment scheme of Chuanjin Qinggan decoction combined with SSRIs can improve the psychological state of patients with herpes zoster complicated by depression and alleviate adverse reactions.展开更多
BACKGROUND Transverse myelitis(TM)is characterized by sudden lower extremity progressive weakness and sensory impairment,and most patients have a history of advanced viral infection symptoms.A variety of disorders can...BACKGROUND Transverse myelitis(TM)is characterized by sudden lower extremity progressive weakness and sensory impairment,and most patients have a history of advanced viral infection symptoms.A variety of disorders can cause TM in association with viral or nonviral infection,vascular,neoplasia,collagen vascular,and iatrogenic,such as vaccination.Vaccination has become common through the global implementation against coronavirus disease 2019(COVID-19)and reported complications like herpes zoster(HZ)activation has increased.CASE SUMMARY This is a 68-year-old woman who developed multiple pustules and scabs at the T6-T9 dermatome site 1 wk after vaccination with the COVID-19 vaccine(Oxford/AstraZeneca([ChAdOx1S{recombinant}]).The patient had a paraplegia aggravation 3 wk after HZ symptoms started.Spinal magnetic resonance imaging(MRI)showed transverse myelitis at the T6–T9 Level.Treatment was acyclovir with steroids combined with physical therapy.Her neurological function was slowly restored by Day 17.CONCLUSION HZ developed after COVID-19 vaccination,which may lead to more severe complications.Therefore,HZ treatment itself should not be delayed.If neurological complications worsen after appropriate management,an immediate diagnostic procedure,such as magnetic resonance imaging and laboratory tests,will start and should treat the neurological complications.展开更多
Dear editor,Unilateral laterothoracic exanthem(ULE),also called superimposed lateralized exanthema or asymmetric periflexural exanthem of childhood,is mostly seen in children aged between 1-5 years[1].It is often prec...Dear editor,Unilateral laterothoracic exanthem(ULE),also called superimposed lateralized exanthema or asymmetric periflexural exanthem of childhood,is mostly seen in children aged between 1-5 years[1].It is often preceded by a respiratory or gastrointestinal symptom.The eruption is usually unilateral,spreading centrifugally,which may present as maculopapular,eczematous or scarlatiniform lesions[2,3].The proposed etiologies include viral infections such as adenovirus,parvovirus,Epstein-Barr virus and most recently,the SARS-CoV-19 virus[4,5].This entity is quite rare in adults.Herein we present a case of ULE in a COVID-19 positive adult male.The condition is mostly self-limiting and requires symptomatic management.展开更多
基金supported by the Operation of Public Health Emergency Response Mechanism of the Chinese Center for Disease Control and Prevention(10239322002001,0000017)Research on Vaccine Evaluation Strategy and capacity Building Project(09207).
文摘Herpes zoster(HZ)is a painful condition resulting from reactivation of dormant varicella-zoster virus(VZV)in a previously VZV-infected person[1].Typical clinical manifestation of HZ are unilateral radicular pain and a vesicular rash limited to one side of the body in the distribution of a nerve[2].The most common complication of HZ postherpetic neuralgia(PHN).
文摘BACKGROUND Intestinal obstruction is a common occurrence in clinical practice.However,the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare.In the diagnostic and treatment process,clinicians consider it crucial to identify the primary causes of its occurrence to ensure effective treatment and avoiding misdiagnosis.CASE SUMMARY Herein,we present the case of a 40-year-old female patient with intestinal obstruction who underwent laparoscopic appendectomy and developed herpes zoster after surgery.Combining the patient's clinical manifestations and relevant laboratory tests,it was suggested that the varicella zoster virus reactivated during the latent period after abdominal surgery,causing herpes zoster.Subsequently,the herpes virus invaded the visceral nerve fibers,causing gastrointestinal dysfunction and loss of intestinal peristalsis,which eventually led to intestinal obstruction.The patient was successfully treated through conservative treatment and antiviral therapy and subsequently discharged from the hospital.CONCLUSION Pseudo-intestinal obstruction secondary to herpes zoster infection is difficult to distinguish from mechanical intestinal obstruction owing to various causes.In cases of inexplicable intestinal obstructions,considering the possibility of a viral infection is essential to minimize misdiagnosis and missed diagnoses。
文摘BACKGROUND Herpes zoster is caused by reactivation of latent varicella-zoster virus infection within the sensory nerve ganglion of the spinal or cranial nerves.Laryngeal herpes zoster is rare and involves superior laryngeal nerve,which leads to several complications such as throat pain,and cough.CASE SUMMARY Patient concerns:A 52-year old woman presented with a 70 d history of throat pain and a 67 d history of non-productive cough.Three days after onset of pain,she was diagnosed with laryngeal herpes zoster.Flexible nasolaryngoscopy revealed multiple white ulcerated lesions on the left hemi epiglottis and the left supraglottic area.She was prescribed with 750 mg famciclovir a day for 7 d,and 150 mg pregabalin,100 mg tramadol and 10 mg nortriptyline a day for 67 d.However,despite of these medications,she complained of pain and persistent cough.Therefore,superior laryngeal nerve block under ultrasound guidance was performed.Three days after the intervention,the throat pain and cough disappeared.The patient remained symptom-free at 3 mo follow-up.CONCLUSION A superior laryngeal nerve block can be an effective option for treatment of pain and cough following laryngeal herpes zoster.
基金This study was reviewed and approved by Yantai Hospital of Traditional Chinese Medicine.
文摘BACKGROUND Western medicine is beneficial for the recovery of neurological function in patients with depression,but some patients experience side effects such as headaches,dizziness,nausea,gastrointestinal symptoms,insomnia,and cardiac dysfunction.In recent years,integrative medicine has achieved positive results in the treatment of various diseases.AIM To study Chuanjin Qinggan decoction combined with selective serotonin reuptake inhibitors(SSRIs)in patients with herpes zoster complicated by depression.METHODS Patients with herpes zoster complicated by depression who were treated at the Yantai Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were retrospectively selected as research participants.Among them,43 patients with herpes zoster complicated by depression who received SSRI treatment between January and December 2021 were assigned to the Western medicine group,while those who received combined treatment of traditional Chinese and Western medicine between January and December 2022 were assigned to the combined group.Both groups were treated for eight weeks.The degree of pain,effect of herpes zoster treatment,degree of improvement in depressive symptoms,serum neurotransmitter levels,sleep quality,and occurrence of adverse reactions were compared between the two groups.RESULTS We found that after eight weeks of drug treatment,the two treatment schemes achieved differing efficacy.In further comparison,we found that,compared with patients treated with SSRIs alone,patients treated with Chuanjin Qinggan decoction combined with SSRIs showed more significant improvement in depression and a greater increase in dopamine and 5-hydroxytryptamine levels after treatment(P<0.05).Patients treated with Chuanjin Qinggan decoction combined with SSRIs also experienced lower pain,better treatment efficacy for herpes zoster,better sleep quality,and a lower incidence of adverse reactions compared to those treated with SSRIs alone(P<0.05).All minor adverse reactions occurring during treatment were resolved after symptomatic treatment.CONCLUSION The treatment scheme of Chuanjin Qinggan decoction combined with SSRIs can improve the psychological state of patients with herpes zoster complicated by depression and alleviate adverse reactions.
基金Supported by Research fund from Chosun University Hospital,2022.
文摘BACKGROUND Transverse myelitis(TM)is characterized by sudden lower extremity progressive weakness and sensory impairment,and most patients have a history of advanced viral infection symptoms.A variety of disorders can cause TM in association with viral or nonviral infection,vascular,neoplasia,collagen vascular,and iatrogenic,such as vaccination.Vaccination has become common through the global implementation against coronavirus disease 2019(COVID-19)and reported complications like herpes zoster(HZ)activation has increased.CASE SUMMARY This is a 68-year-old woman who developed multiple pustules and scabs at the T6-T9 dermatome site 1 wk after vaccination with the COVID-19 vaccine(Oxford/AstraZeneca([ChAdOx1S{recombinant}]).The patient had a paraplegia aggravation 3 wk after HZ symptoms started.Spinal magnetic resonance imaging(MRI)showed transverse myelitis at the T6–T9 Level.Treatment was acyclovir with steroids combined with physical therapy.Her neurological function was slowly restored by Day 17.CONCLUSION HZ developed after COVID-19 vaccination,which may lead to more severe complications.Therefore,HZ treatment itself should not be delayed.If neurological complications worsen after appropriate management,an immediate diagnostic procedure,such as magnetic resonance imaging and laboratory tests,will start and should treat the neurological complications.
文摘Dear editor,Unilateral laterothoracic exanthem(ULE),also called superimposed lateralized exanthema or asymmetric periflexural exanthem of childhood,is mostly seen in children aged between 1-5 years[1].It is often preceded by a respiratory or gastrointestinal symptom.The eruption is usually unilateral,spreading centrifugally,which may present as maculopapular,eczematous or scarlatiniform lesions[2,3].The proposed etiologies include viral infections such as adenovirus,parvovirus,Epstein-Barr virus and most recently,the SARS-CoV-19 virus[4,5].This entity is quite rare in adults.Herein we present a case of ULE in a COVID-19 positive adult male.The condition is mostly self-limiting and requires symptomatic management.
文摘目的 探讨带状疱疹脑膜炎患者的认知功能变化。方法 选取2020年1月至2022年12月经脑脊液水痘-带状疱疹病毒DNA确诊的带状疱疹脑膜炎患者23例及健康体验者28例(对照组),采用蒙特利尔认知评价量表(MoCA)评估其认知功能,并分析患者的认知功能改变。结果 23例带状疱疹脑膜炎患者有6例患者存在认知功能下降。与对照组比较,带状疱疹脑膜炎患者MoCA评分(25.88±2.31 VS.27.61±1.81)明显降低(P<0.05);其中视空间执行功能(3.29±1.12 VS. 4.11±0.92)、延迟回忆(4.21±0.66 VS. 4.57±0.50)明显降低,差异有统计学意义(P<0.05)。结论 带状疱疹脑膜炎患者早期可出现以视空间执行功能、延迟回忆为主的认知障碍,临床医师要重视带状疱疹脑膜炎患者的认知功能筛查。
