PDF(Pubmed)
Abstract：
Herpes zoster infection is more frequent and severe in the immunocompromised population. Its incidence is significantly higher in this population when compared to immunocompetent individuals. The authors present a case of an 88-year-old man with a history of arterial hypertension and myelodysplastic syndrome. The patient was evaluated in the emergency department (ED) for edema of the frontal facial region with left periorbital involvement and multiple purulent vesicles. He was diagnosed with viral infection by herpes zoster and was prescribed valaciclovir and deflazacort. He returned two days later due to an increase in the lesions affecting the left hemi-cranium, with decreased visual acuity and painless purulent drainage in the ipsilateral eye. The ophthalmological evaluation revealed exuberant edema with associated chemosis and involvement of the cornea of the affected eye. He was hospitalized and began antiviral therapy with intravenous acyclovir and chloramphenicol with topical ganciclovir. There was a progressive resolution of the skin lesions but no reversal of the loss of vision in the affected eye. Herpes zoster infection is more frequent and severe in the immunocompromised population. The clinical presentation is often similar to that of the immunocompetent population; however, it can have exuberant manifestations. The authors emphasize the need for close clinical monitoring of the immunocompromised patient with herpes zoster infection and review the role of corticosteroids when treating this particular population.
摘要：
在免疫功能低下的人群中，带状疱疹感染更为频繁和严重。与具有免疫能力的个体相比，该人群的发病率明显更高。作者介绍了一例88岁男性，有动脉高血压和骨髓增生异常综合征病史。在急诊科（ED）对患者进行了评估，以评估左眶周受累和多个脓性囊泡的额面部水肿。他被诊断为带状疱疹病毒感染，并接受了伐昔洛韦和deflazacort治疗。由于影响左半颅骨的病变增加，他两天后返回，同侧眼视力下降，无痛性脓性引流。眼科评估显示，伴有相关化学沉着和受累眼角膜的旺盛水肿。他住院并开始静脉注射阿昔洛韦和氯霉素以及局部更昔洛韦的抗病毒治疗。在受影响的眼睛中，皮肤病变逐渐消退，但视力丧失没有逆转。在免疫功能低下的人群中，带状疱疹感染更为频繁和严重。临床表现通常与免疫活性人群相似；然而，它可以有旺盛的表现。作者强调需要对患有带状疱疹感染的免疫功能低下患者进行密切的临床监测，并在治疗该特定人群时回顾皮质类固醇的作用。
