Garcia Joshua M, Haddadin Ramez I
Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
IDCases. 2024 Aug 28;37:e02070. doi: 10.1016/j.idcr.2024.e02070. eCollection 2024.
Immunizations have long been pivotal in preventing diseases like HZ (herpes zoster), caused by VZV (varicella zoster virus). This study aims to evaluate the efficacy and safety of the RZV (recombinant zoster vaccine) compared to the ZVL (zoster vaccine live) and to report rare adverse events following RZV administration.
Herein, we report an unusual case of a 59-year-old man who developed a V1-limited rash with a positive HZ PCR (polymerase chain reaction) test following administration of RZV in the United States.
The development of RZV has significantly improved the prevention of HZ compared to ZVL. Nevertheless, rare adverse events, such as dermatomal reactions, underscore the importance of ongoing monitoring and research into the immunomodulatory effects of RZV. Physicians should continue to administer the RZV to patients but be cognizant that reactivation may rarely subsequently occur.
The patient with a history of benign prostatic hyperplasia was treated at an outside hospital two days after receiving the RZV complaining of paresthesia and a rash on his nasolacrimal area and forehead. The patient presented to the ED (emergency department), 9 days post-vaccination due to persistence of his symptoms despite use of amoxicillin, valacyclovir, and an unidentified eye drop. The dose of valacyclovir was increased, and he completed 1 g TID (three times a day) PO (per orally) for 10 days with subsequent resolution of symptoms. A positive PCR test confirmed the diagnosis of HZ. Topical mupirocin ointment was initiated and the patient was referred for ophthalmologic evaluation.
长期以来，免疫接种在预防由水痘带状疱疹病毒（VZV）引起的带状疱疹（HZ）等疾病方面一直起着关键作用。本研究旨在评估重组带状疱疹疫苗（RZV）与减毒活疫苗（ZVL）相比的疗效和安全性，并报告RZV接种后罕见的不良事件。
在此，我们报告一例不寻常的病例，一名59岁男性在美国接种RZV后出现V1区域局限性皮疹，HZ聚合酶链反应（PCR）检测呈阳性。
与ZVL相比，RZV的研发显著改善了HZ的预防效果。然而，罕见的不良事件，如皮疹反应，凸显了持续监测和研究RZV免疫调节作用的重要性。医生应继续为患者接种RZV，但要认识到随后可能很少会出现再激活情况。
该患者有良性前列腺增生病史，在接种RZV两天后因鼻泪区域和前额出现感觉异常及皮疹，在外院接受治疗。接种疫苗9天后，尽管使用了阿莫西林、伐昔洛韦和一种不明眼药水，症状仍持续，患者前往急诊室（ED）就诊。伐昔洛韦剂量增加，患者口服1克，每日三次，持续10天，随后症状缓解。PCR检测呈阳性确诊为HZ。开始使用莫匹罗星软膏局部治疗，并将患者转诊进行眼科评估。
