Steinberg Corey J, Moody Austin D, Yenior Ashley L, Bertasi Raphael A O, Kieneker Lisa, Pujalte George G A
Department of Family Medicine, Mayo Clinic, Jacksonville, FL, United States.
IDCases. 2020 Jul 4;21:e00902. doi: 10.1016/j.idcr.2020.e00902. eCollection 2020.
Herpes zoster is a common infection resulting from the reactivation of dormant varicella zoster virus in a posterior dorsal root ganglion. The typical dermatomal involvement includes the thoracic region, followed by the face and the cervical and lumbosacral regions, with 1% having disseminated disease. We present a rare case of an immunocompetent 85-year-old man presenting with herpes zoster at the L3-S2 dermatomes, that evolved to disseminated varicella zoster virus (dVZV), with radiologically and laboratory-confirmed lumbosacral plexopathy manifesting with cauda equina syndrome. Here we also discuss the diagnosis and complications of dVZV as well as treatment strategy. By maintaining a high degree of clinical suspicion and initiating early treatment, high-quality patient care and good outcomes are able to be achieved in cases like this.
带状疱疹是由后根神经节中潜伏的水痘-带状疱疹病毒重新激活引起的常见感染。典型的皮节受累包括胸部区域，其次是面部以及颈部和腰骶部区域，1%的患者会出现播散性疾病。我们报告了一例罕见病例，一名85岁免疫功能正常的男性，在L3-S2皮节出现带状疱疹，随后发展为播散性水痘-带状疱疹病毒（dVZV），经影像学和实验室检查确诊为腰骶丛神经病，并伴有马尾综合征。在此，我们还讨论了dVZV的诊断、并发症及治疗策略。通过保持高度的临床怀疑并尽早开始治疗，这类病例能够实现高质量的患者护理并取得良好的治疗效果。
