Warman Meir, Halperin Doron
Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, Rehovot.
Harefuah. 2007 Feb;146(2):89-91, 167.
Herpes zoster is an infection caused by reactivation of the latent varicella virus in the sensory ganglia. The mechanisms responsible for Varicella zoster virus (VZV) reactivation are poorly understood. Yet, it is believed that decreased cellular immunity can be a trigger for it's reactivation. The occurrence of herpes zoster in young people may point to an underlying immunodeficiency. Therefore, the possibility of concomitant HIV infection must be eliminated. Herpes zoster manifests as a vesicular rash along a sensory dermatome, usually preceded by pain or paresthesia of the involved cutaneous area. The most commonly affected dermatomes are those of the thorax and abdomen, followed by the cranial nerves, especially the trigeminal nerve. The maxillary nerve is the least frequently affected branch of the trigeminal nerve and only rarely causes ocular injury. This is a case history of a young patient infected with VZV involving the maxillary branch of the trigeminal nerve, complicated by secondary bacterial infection of the ipsilateral hemiface. The literature regarding the epidemiology, pathogenesis, complications and the proper treatment of herpes zoster is reviewed with an emphasis on the involvement of cranial nerves.
带状疱疹是由感觉神经节中潜伏的水痘病毒重新激活引起的一种感染。水痘带状疱疹病毒(VZV)重新激活的机制尚不清楚。然而,据信细胞免疫功能下降可能是其重新激活的一个触发因素。年轻人中带状疱疹的出现可能表明存在潜在的免疫缺陷。因此,必须排除合并HIV感染的可能性。带状疱疹表现为沿感觉皮节的水疱性皮疹,通常在受累皮肤区域出现疼痛或感觉异常之前出现。最常受累的皮节是胸部和腹部的皮节,其次是颅神经,尤其是三叉神经。上颌神经是三叉神经中最少受累的分支,很少引起眼部损伤。这是一例感染VZV累及三叉神经上颌支的年轻患者的病例史,并发同侧半侧面部的继发性细菌感染。本文回顾了关于带状疱疹的流行病学、发病机制、并发症及正确治疗的文献,重点关注颅神经受累情况。