Curtis Kelly K, Connolly Megan K, Northfelt Donald W
Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ, USA.
J Gen Intern Med. 2008 May;23(5):648-9. doi: 10.1007/s11606-008-0558-4. Epub 2008 Feb 20.
A vaccine for the prevention of herpes zoster outbreaks in adults over the age of 60 years has recently been approved. A 76-year-old white female with a history of recurrent left axillary breast cancer undergoing chemotherapy was given a Zostavax injection by her primary care physician. Eight days later, the patient developed a rash. Given the recent administration of live, attenuated varicella zoster virus (VZV), a diagnosis of disseminated cutaneous herpes zoster was made. The patient was treated successfully with a course of famciclovir for 10 days and cephalexin for 7 days for a secondary bacterial infection. A review of the medical literature disclosed no reports of Zostavax given to adult cancer patients immunocompromised by systemic chemotherapy. Therefore, we believe this report is the first to describe the consequences of Zostavax administration to such a host. Clinicians should take care to review contraindications and precautions prior to administering the Zostavax vaccine.
一种预防60岁以上成年人带状疱疹发作的疫苗最近已获批准。一名76岁有复发性左腋窝乳腺癌病史且正在接受化疗的白人女性，其初级保健医生为她注射了一剂Zostavax疫苗。八天后，该患者出现皮疹。鉴于近期接种了减毒活水痘带状疱疹病毒（VZV），诊断为播散性皮肤带状疱疹。该患者接受了一个疗程的泛昔洛韦治疗10天，并使用头孢氨苄治疗7天以应对继发性细菌感染，治疗成功。对医学文献的回顾未发现关于给因全身化疗而免疫功能低下的成年癌症患者接种Zostavax疫苗的报告。因此，我们认为本报告是首次描述给此类宿主接种Zostavax疫苗的后果。临床医生在接种Zostavax疫苗前应注意查看禁忌症和预防措施。
