CLINICAL PRESENTATION: A 41-year-old man with a history of VZV presented with a 6-month history of chest pain, flulike symptoms, and left-sided headaches. [ncbi.nlm.nih.gov]

• Varicella-Zoster Virus Infection

  Varicella zoster virus infection acquired in pregnancy is reported to cause fetal damage in 5% to 10% of cases. We used polymerase chain reaction to attempt molecular diagnosis of fetoplacental varicella zoster virus infection in two patients. [ncbi.nlm.nih.gov]

  Picture of Varicella-Zoster Virus Infection on Chest Wall Varicella -zoster virus infection: herpes zoster in T8 to T10 dermatomes. [medicinenet.com]

• Inflammation

  KEYWORDS: ARPE-19; RPE (retinal pigment epithelium); VZV; inflammation; viral uveitis [ncbi.nlm.nih.gov]

  Inflamm Bowel Dis. 2012;18:34-40. REVIEW Varicella Zoster Virus Infection in Patients with Inflammatory Bowel Disease Maggie Ham, MD 1 Garret Cullen, MD 2 Adam S. [gastroenterologyandhepatology.net]

  They are also more susceptible to both pneumonia and brain inflammation, so being seen by a doctor early on for anti-viral treatment is important. [healthline.com]

  Chickenpox in adults is more severe and may be complicated by pneumonia (lung infection or inflammation). Chickenpox may be particularly severe in children with leukaemia, pregnant women and young babies. [sahealth.sa.gov.au]

• Asymptomatic

  OBJECTIVE: It is known that varicella-zoster virus (VZV) can cause asymptomatic infections, but it has not been described that congenital infection can be caused by maternal subclinical infection. [ncbi.nlm.nih.gov]

  Key Points Herpes simplex viruses 1 and 2 (HSV-1 and HSV-2) can cause both primary and recurrent symptomatic or asymptomatic infections, mainly involving the orolabial and genital areas. [medicinetoday.com.au]

• Fatigue

  […] nausea, vomiting 35-800 mg tabs; $70 valacyclovir 2-18 years old; 20 mg/kg 3x/day; max. 1g 3x/day; 5 days 2 1 g 3x/day; 7 days 2 headache, nausea, abdominal pain 21-1 g tabs; $220 famciclovir not established 500 mg 3x/day 3 ; 7 days 2 headache, nausea, fatigue [antimicrobe.org]

• Burning Pain

  Zoster is preceded by a prodromal phase with burning pains and/or sensory disturbances in the area of one to three adjoining dermatomes. [egms.de]

• Cough

  Chickenpox and shingles are notifiable conditions 1 How chickenpox and shingles are spread Chickenpox is spread when an infected person talks, breathes, coughs or sneezes tiny particles containing infectious agents into the air. [sahealth.sa.gov.au]

  Pathogenesis Transmission Varicella-zoster virus development [4] The virus can be spread through direct contact with blisters, saliva, or mucus of a person infected with chickenpox and spread through the air by coughing and sneezing. [microbewiki.kenyon.edu]

  Chest radiography is warranted for patients who experience dyspnea, cough, or other respiratory symptoms. [hivinsite.ucsf.edu]

• Sneezing

  Chickenpox and shingles are notifiable conditions 1 How chickenpox and shingles are spread Chickenpox is spread when an infected person talks, breathes, coughs or sneezes tiny particles containing infectious agents into the air. [sahealth.sa.gov.au]

  Pathogenesis Transmission Varicella-zoster virus development [4] The virus can be spread through direct contact with blisters, saliva, or mucus of a person infected with chickenpox and spread through the air by coughing and sneezing. [microbewiki.kenyon.edu]

• Diarrhea

  […] days 2 10-15 mg/kg every 8h; 5-7 days 2 phlebitis, acute renal failure, nausea, vomiting, rash foscarnet 4 not established 180 mg/kg/day in 2-3 divided doses; 7-14 days 2 fever, headache, renal dysfunction, electrolyte abnormalities, nausea, vomiting diarrhea [antimicrobe.org]

• Myalgia

  […] a higher incidence of the secondary zoster infection in early stages of life. 7,8 Clinical Manifestations and Laboratory Findings Varicella is characterized by a generalized itchy, blister-like rash, usually associated with fever, headache, malaise, myalgia [uspharmacist.com]

  Prodromal symptoms often occur in adults 1-2 days before the appearance of the rash, and may include malaise, low-grade fever, and myalgia. [hivinsite.ucsf.edu]

• Muscle Weakness

  Geniculate zoster causes weakness or paralysis of ipsilateral facial muscles. [antimicrobe.org]

• Skin Lesion

  We report the syndrome of inappropriate antidiuretic hormone secretion (SIADH) preceding the development of skin lesions of varicella zoster virus (VZV) infection in a patient with CML 5 months post-allogeneic BMT. [ncbi.nlm.nih.gov]

  Early in the twentieth century, similarities in the histopathologic features of skin lesions resulting from varicella and herpes zoster were demonstrated. [accessmedicine.mhmedical.com]

• Eczema

  Two patients had disseminated infection without a vesicular stage; one patient had underlying asteatotic eczema. All responded well to acyclovir. [ncbi.nlm.nih.gov]

• Cutaneous Manifestation

  In most instances of cutaneous manifestations, the diagnostic procedure of choice is the demonstration of virus antigens on cells obtained directly from cutaneous lesions. [hivinsite.ucsf.edu]

• Headache

  Author information 1 Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taiwan. [email protected] Abstract A nummular headache (NH) is a type of primary headache that results from cranial [ncbi.nlm.nih.gov]

  There was no headache, petechiae or neck stiffness, and no lumbar puncture was performed. [scholarlypages.org]

  Society, California Medical Association, California Neurology Society, International Headache Society, San Francisco Medical Society, San Francisco Neurological Society Disclosure: Nothing to disclose. [emedicine.medscape.com]

  Common adverse effects of VariZIG include reactions at the injection site and headaches. The recommended dose of VariZIG is 125 IU/10 kg of body weight (≤625 IU). [uspharmacist.com]

• Stroke

  Furthermore, other zoster complications can develop, including myelitis, cranial nerve palsies, meningitis, stroke (vasculopathy), retinitis, and gastroenterological infections such as ulcers, pancreatitis and hepatitis. [ncbi.nlm.nih.gov]

  Our impression is that clinicians rarely consider possible varicella zoster virus infection in cases of stroke. However, sequelae in the form of stroke after chickenpox or herpes zoster do occur ( 5 ). [tidsskriftet.no]

  […] meningoencephalitis and cerebellitis, single or multiple cranial nerve palsies (polyneuritis cranialis), myelopathy (myelitis and spinal cord infarction), and VZV vasculopathy of intracerebral and extracerebral arteries that causes ischemic or hemorrhagic stroke [journals.lww.com]

  Increased risk of stroke after a herpes zoster attack: a population-based follow-up study. Stroke 2010; 40:3443-8. [P ubMed] 6 3. [antimicrobe.org]

• Dizziness

  […] tramadol 25-50 mg 2x/day increase 50-100 mg/day in divided doses every 2 days as tolerated 100 mg 4x/day nausea, vomiting, constipation, somnolence, dizziness, seizures, postural hypotension Figure 1. [antimicrobe.org]

  Symptoms usually develop 3-8 days after onset of chickenpox and 1-2 weeks after development of zoster.(29) Encephalitis occurs more frequently with zoster in the ophthalmic distribution, and cerebellar findings are typical, including ataxia, tremors, and dizziness [hivinsite.ucsf.edu]

• Somnolence

  Somnolence could be a part of the clinical presentation, it is well described that considerable viremia of herpes viruses may lead to spill-over into CNS [ 12 ]. [scholarlypages.org]

  dizziness tramadol 25-50 mg 2x/day increase 50-100 mg/day in divided doses every 2 days as tolerated 100 mg 4x/day nausea, vomiting, constipation, somnolence, dizziness, seizures, postural hypotension Figure 1. [antimicrobe.org]

• Lethargy

  Corticocerebral involvement may result in headache, vomiting, and lethargy. Cerebrospinal fluid (CSF) findings usually are nonspecific, showing mononuclear pleocytosis, elevated protein concentration, and negative viral cultures. [hivinsite.ucsf.edu]

[…] acyclovir-resistant VZV, detections of mutations in thymidine kinase can be determined by PCR and sequence analysis MRI may be useful if myelitis or encephalitis is suspected Lumbar puncture may be helpful if signs suggest myelitis or encephalitis See Workup [emedicine.medscape.com]

Varicella zoster virus (VZV) infection involving the posterior segment of the eye after fludarabine treatment has not previously been described. [ncbi.nlm.nih.gov]

What should you tell the family about the patient's prognosis? The most common complication of chickenpox is secondary skin infection, usually with a Gram-positive organism. Rarer complications include infection of the central nervous system (CNS). [infectiousdiseaseadvisor.com]

Several concomitant external calvarial lesions were identified, and imaging was concerning for an infectious or neoplastic etiology. The patient underwent surgical debridement, and pathologic samples identified coinfection with P. acnes and VZV. [ncbi.nlm.nih.gov]

• Identifying varicella-zoster virus as the etiology of CNS involvement can be challenging especially in the setting of no preceding rash. [medlink.com]

J Immunol May 1, 2016, 196 (1 Supplement) 217.33; Abstract Varicella zoster virus (VZV) is the etiological agent of shingles, a painful skin rash that affects a significant proportion of the elderly population. [jimmunol.org]

Results show that the overall epidemiology of varicella and zoster is remarkably similar between the two countries. [researchonline.lshtm.ac.uk]

The policy of universal vaccination of susceptible children and adults has had a profound effect on the epidemiology of varicella. [nejm.org]

The sero-epidemiological profile in Italy is different from that in other European countries. [bmcpublichealth.biomedcentral.com]

The diagnosis was reached by clinical, epidemiological and serological means. The second patient was a 13-year-old boy with EM which was followed 2 weeks later by Ramsay-Hunt syndrome. [ncbi.nlm.nih.gov]

The impact of the varicella vaccination program on herpes zoster epidemiology in the United States: a review. J Infect Dis 2008;197(Suppl 2):S224–S227. [health.gov.au]

In this narrative review we focus on the pathophysiology of VZV infection and the role of TNF, and report the available data about VZV outbreaks recorded on Registries of rheumatic patients treated with anti-TNF agents. [ncbi.nlm.nih.gov]

Historically, children between the ages of 1 and 4 years accounted for 39% of cases, while children aged 5 to 9 years and adults ≥20 years accounted for 38% and 7%, respectively (National Health Interview Survey data, 1990-1994). 5 Transmission and Pathophysiology [uspharmacist.com]

Pathophysiology The host immunologic mechanisms suppress replication of the virus. Reactivation can occur if host immune mechanisms are compromised. [emedicine.medscape.com]

Prevention is paramount to management. [ncbi.nlm.nih.gov]

Prevention and Prophylaxis Varicella Vaccine: Varivax (Merck & Co., Inc.), a single-agent vaccine containing a live, attenuated (Oka strain) virus, is recommended to prevent varicella infection in healthy persons >12 months of age who do not have any [uspharmacist.com]

New knowledge regarding the infectiousness and less frequent clinical manifestations of the varicella zoster virus should have consequences for infection prevention and control, clinical diagnostics and treatment. [tidsskriftet.no]

Prevention is paramount to management. Test your knowledge on chicken pox and pregnancy with MD-IQ: the medical intelligence quiz. Click here to answer 5 questions. [mdedge.com]