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Retrospective evaluation of clinical features in hospitalized herpes zoster patients

Year 2022, Volume: 61 Issue: 1, 58 - 63, 15.03.2022

Ayda Acar , Ayşe Hande Yoldaş , Işıl Karaarslan , İlgen Ertam , Can Ceylan , İdil Ünal , Günseli Öztürk

https://doi.org/10.19161/etd.1085700
Cited By: 1

Abstract

Aim: Herpes zoster is a dermatomal vesicular eruption caused by the reactivation of varicella-zoster virus (VZV) that remains latent in the dorsal root ganglia. Due to the impairment of cellular immune capacity with aging, it is commonly seen in advanced age. Approximately 3-10% of the cases need to be hospitalized. We aimed to determine the frequency of dissemination and the demographic and clinical characteristics in hospitalized herpes zoster patients in a dermatology clinic of a tertiary hospital.
Materials and Methods: The records of 19 herpes zoster patients hospitalized in our clinic between June 2019 and November 2020 were retrospectively reviewed. Patients' age, gender, dermatome involved, presence of dissemination, concomitant diseases, and development of post-herpetic neuralgia were noted.
Results: Disseminated herpes zoster was seen in 36.8% (no:7) of the patients. Of patients 63.2% (no:12) had ophthalmic herpes zoster. The relationship between dissemination and age, gender, presence of immunosuppression and development of post-herpetic neuralgia was not statistically significant. While no death was observed in the non-disseminated group, one patient died in the disseminated herpes zoster group.
Conclusion: In this study, the mean age of the patients, the accompanying immunosuppressive state, and the rate of post-herpetic neuralgia were found to be higher in the disseminated herpes zoster group than the non-disseminated group. But it was not significant. Studies on disseminated herpes zoster which have a higher mortality are limited due to the low frequency of the disease. Studies involving larger numbers of patients are needed in order to report the clinical features and mortality rates more clearly in these patients.

Keywords

herpes zoster disseminated herpes zoster immunosuppression

References

  • Kennedy PGE, Gershon AA. Clinical Features of Varicella-Zoster Virus Infection. Viruses. 2018; 10 (11): 609.
  • Johnson RW, Levin MJ. Herpes Zoster and Its Prevention by Vaccination. Interdiscip Top Gerontol Geriatr. 2020; 43: 131-45.
  • Bollea-Garlatti ML, Bollea-Garlatti LA, Vacas AS et al. Clinical Characteristics and Outcomes in a Population with Disseminated Herpes Zoster: A Retrospective Cohort Study. Actas Dermosifiliogr. 2017; 108 (2): 145-52.
  • Gross GE, Eisert L, Doerr HW et al. S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. J Dtsch Dermatol Ges. 2020; 18 (1): 55-78.
  • Dworkin RH, Johnson RW, Breuer J et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007; 44 Suppl 1:S1-26.
  • Vukelić D, Oroši Končić D, Prepolec J et al. Clinical characteristics of hospitalized adults and adolescents with herpes zoster in Croatia: more than 20 years of a single-center experience. Croat Med J. 2020; 61 (5): 401-9.
  • Yin D, Van Oorschot D, Jiang N et al. A systematic literature review to assess the burden of herpes zoster disease in China. Expert Rev Anti Infect Ther. 2020:1-15.
  • Nair PA, Patel BC. Herpes Zoster. 2021 Nov 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.
  • Pitton Rissardo J, Fornari Caprara AL. Herpes Zoster Oticus, Ophthalmicus, and Cutaneous Disseminated: Case Report and Literature Review. Neuroophthalmology. 2018; 43 (6):407-10.
  • Chen LK, Arai H, Chen LY et al. Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific. BMC Infect Dis. 2017; 17(1): 213.
  • Sayeeda A, Al Arfaj H, Khalil N, Al Arfaj AS. Herpes Zoster Infections in SLE in a University Hospital in Saudi Arabia: Risk Factors and Outcomes. Autoimmune Dis. 2010; 2011: 174891.
  • Ahronowitz I, Fox LP. Herpes zoster in hospitalized adults: Practice gaps, new evidence, and remaining questions. J Am Acad Dermatol. 2018; 78 (1): 223-30.e3.
  • Bader MS. Herpes zoster: diagnostic, therapeutic, and preventive approaches. Postgrad Med. 2013; 125 (5): 78-91.
  • Le P, Rothberg M. Herpes zoster infection. BMJ. 2019; 364: k5095.
  • Esteban-Vasallo MD, Domínguez-Berjón MF, Gil-Prieto R, Astray-Mochales J, Gil de Miguel A. Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster: a population-based study from primary care in Madrid (Spain). Hum Vaccin Immunother. 2014; 10 (6): 1650-60.
  • Özkol HU, Bilgili SG, Karadag AS, Altun F, Calka O. The Evaluation Clinical and Demographic Characteristics of 115 Patients Diagnosed with Herpes Zoster in Eeastern Turkey. Turk J Dermatol 2013; 7: 201-5.
  • Köse Ş, Atalay S, Gül S, Sönmez U, Ödemiş İ. Tepecik Eğit Hast Derg 2013; 23 (2): 89-92.
  • Buchan SA, Daneman N, Wang J et al. Incidence of Hospitalizations and Emergency Department Visits for Herpes Zoster in Immunocompromised and Immunocompetent Adults in Ontario, Canada, 2002-2016. Clin Infect Dis. 2020; 71 (1): 22-9.

Hastanede yatırılarak izlenen herpes zoster hastalarının retrospektif olarak değerlendirilmesi

Year 2022, Volume: 61 Issue: 1, 58 - 63, 15.03.2022

Ayda Acar , Ayşe Hande Yoldaş , Işıl Karaarslan , İlgen Ertam , Can Ceylan , İdil Ünal , Günseli Öztürk

https://doi.org/10.19161/etd.1085700
Cited By: 1

Abstract

Amaç: Herpes zoster dorsal kök gangliyonlarında latent kalan varisella zoster virüsün reaktive olmasıyla gelişen dermatomal veziküler erüpsiyondur. Yaş alma ile birlikte görülen hücresel bağışıklık kapasitesindeki azalma nedeniyle çoğunlukla ileri yaşta görülmektedir. Olgularının yaklaşık %3-10’unun hastaneye yatarak tedavi alması gerekir. Bu çalışmada kliniğimizde yatırılarak izlenen herpes zoster olgularının retrospektif olarak değerlendirilerek disseminasyon sıklığının ve bu hastalardaki demografik ve klinik özelliklerin saptanması amaçlanmıştır.
Gereç ve Yöntem: Haziran 2019 ile Kasım 2020 tarihleri arasında kliniğimizde yatarak izlenen 19 herpes zoster olgusunun dosyası retrospektif olarak gözden geçirildi. Hasta dosyalarından hastaların yaşı, cinsiyeti, tutulan dermatom, disseminasyon varlığı, eşlik eden hastalıklar, postherpetik nevralji gelişimi olup olmadığı not edildi.
Bulgular: Dissemine herpes zoster %36,8 (no:7) oranında görüldü. Hastaların %63,2’sinde (no:12) oftalmik herpes zoster mevcuttu. Disseminasyon ile yaş, cinsiyet, immunsupresyon varlığı ve PNH gelişimi arasındaki ilişki istatiksel olarak anlamlı değildi (p:0,051, p:0,216, p: 0,865, p:0,419). Dissemine olmayan hasta grubunda ölüm gözlenmezken dissemine herpes zoster grubunda bir hasta hayatını kaybetti.
Sonuç: Bu çalışmada dissemine herpes zoster olan grupta hastaların yaş ortalaması, eşlik eden immunsupresif durum, post herpetik nevralji gelişim oranı dissemine olmayan gruba göre daha yüksek saptanmıştır fakat bu yükseklik anlamlı bulunmamıştır. Mortalitesi klasik zonaya göre daha yüksek olan dissemine zona ile ilgili çalışmalar hastalığın sık görülmemesi nedeniyle kısıtlıdır. Bu hastalardaki klinik özellikleri ve mortalite oranlarını daha net bildirebilmek için daha fazla sayıda hasta içeren çalışmalara ihtiyaç vardır.

Keywords

herpes zoster dissemine zoster immünsupresyon

References

  • Kennedy PGE, Gershon AA. Clinical Features of Varicella-Zoster Virus Infection. Viruses. 2018; 10 (11): 609.
  • Johnson RW, Levin MJ. Herpes Zoster and Its Prevention by Vaccination. Interdiscip Top Gerontol Geriatr. 2020; 43: 131-45.
  • Bollea-Garlatti ML, Bollea-Garlatti LA, Vacas AS et al. Clinical Characteristics and Outcomes in a Population with Disseminated Herpes Zoster: A Retrospective Cohort Study. Actas Dermosifiliogr. 2017; 108 (2): 145-52.
  • Gross GE, Eisert L, Doerr HW et al. S2k guidelines for the diagnosis and treatment of herpes zoster and postherpetic neuralgia. J Dtsch Dermatol Ges. 2020; 18 (1): 55-78.
  • Dworkin RH, Johnson RW, Breuer J et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007; 44 Suppl 1:S1-26.
  • Vukelić D, Oroši Končić D, Prepolec J et al. Clinical characteristics of hospitalized adults and adolescents with herpes zoster in Croatia: more than 20 years of a single-center experience. Croat Med J. 2020; 61 (5): 401-9.
  • Yin D, Van Oorschot D, Jiang N et al. A systematic literature review to assess the burden of herpes zoster disease in China. Expert Rev Anti Infect Ther. 2020:1-15.
  • Nair PA, Patel BC. Herpes Zoster. 2021 Nov 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.
  • Pitton Rissardo J, Fornari Caprara AL. Herpes Zoster Oticus, Ophthalmicus, and Cutaneous Disseminated: Case Report and Literature Review. Neuroophthalmology. 2018; 43 (6):407-10.
  • Chen LK, Arai H, Chen LY et al. Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific. BMC Infect Dis. 2017; 17(1): 213.
  • Sayeeda A, Al Arfaj H, Khalil N, Al Arfaj AS. Herpes Zoster Infections in SLE in a University Hospital in Saudi Arabia: Risk Factors and Outcomes. Autoimmune Dis. 2010; 2011: 174891.
  • Ahronowitz I, Fox LP. Herpes zoster in hospitalized adults: Practice gaps, new evidence, and remaining questions. J Am Acad Dermatol. 2018; 78 (1): 223-30.e3.
  • Bader MS. Herpes zoster: diagnostic, therapeutic, and preventive approaches. Postgrad Med. 2013; 125 (5): 78-91.
  • Le P, Rothberg M. Herpes zoster infection. BMJ. 2019; 364: k5095.
  • Esteban-Vasallo MD, Domínguez-Berjón MF, Gil-Prieto R, Astray-Mochales J, Gil de Miguel A. Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster: a population-based study from primary care in Madrid (Spain). Hum Vaccin Immunother. 2014; 10 (6): 1650-60.
  • Özkol HU, Bilgili SG, Karadag AS, Altun F, Calka O. The Evaluation Clinical and Demographic Characteristics of 115 Patients Diagnosed with Herpes Zoster in Eeastern Turkey. Turk J Dermatol 2013; 7: 201-5.
  • Köse Ş, Atalay S, Gül S, Sönmez U, Ödemiş İ. Tepecik Eğit Hast Derg 2013; 23 (2): 89-92.
  • Buchan SA, Daneman N, Wang J et al. Incidence of Hospitalizations and Emergency Department Visits for Herpes Zoster in Immunocompromised and Immunocompetent Adults in Ontario, Canada, 2002-2016. Clin Infect Dis. 2020; 71 (1): 22-9.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Ayda Acar 0000-0001-7507-6999

Ayşe Hande Yoldaş 0000-0002-2219-5422

Işıl Karaarslan 0000-0001-5348-027X

İlgen Ertam 0000-0003-2341-3935

Can Ceylan 0000-0001-6528-0566

İdil Ünal 0000-0002-1639-277X

Günseli Öztürk 0000-0002-9936-4116

Publication Date March 15, 2022
Submission Date August 6, 2021
Published in Issue Year 2022 Volume: 61 Issue: 1

Cite

Vancouver Acar A, Yoldaş AH, Karaarslan I, Ertam İ, Ceylan C, Ünal İ, et al. Retrospective evaluation of clinical features in hospitalized herpes zoster patients. EJM. 2022;61(1):58-63.

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https://doi.org/10.1002/ccr3.9607
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