JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Case Report
Zona zoster; an atypical presentation with severe pre-lesion pain: a case report
Abstract
The Varicella Zoster virus can initially cause chickenpox in humans and then become latent. It can later reactivate for various reasons and manifest as shingles in dermatome areas, characterized by redness, rash, and neuropathic pain. In this case, we want to highlight a Zoster case with atypical symptoms resembling acute coronary syndrome, but without the presence of a rash. The patient is a 78-year-old female who presented to the emergency department with complaints of chest pain resembling acute coronary syndrome.

Keywords : Differential diagnosis, atypical zona, acute coronary syndrome

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1. Kennedy PG. Varicella-zoster virus latency in human ganglia.Rev Med Virol. 2002;12(5):327-334.
2. Nagel MA, Gilden DH. The protean neurologic manifestationsof varicella-zoster virus infection. Cleveland Clin J Med. 2007;74(7):489.
3. Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Neurologicaldisease produced by varicella zoster virus reactivation without rash.Varicella-zoster Virus. 2010:243-253. doi.org/10.1007/82_2009_3
4. Gershon AA, Gershon MD. Pathogenesis and current approachesto control of varicella-zoster virus infections. Clin Microbiol Rev.2013;26(4):728-743.
5. Furuta Y, Ohtani F, Aizawa H, Fukuda S, Kawabata H, BergströmT. Varicella-zoster virus reactivation is an important cause ofacute peripheral facial paralysis in children. Pediatr Infect Dis J.2005;24(2):97-101.
6. Breuer J, Pacou M, Gautier A, Brown MM. Herpes zoster as a riskfactor for stroke and TIA: a retrospective cohort study in the UK.Neurol. 2014;83(2):e27-e33.
7. Patil A, Goldust M, Wollina U. Herpes zoster: a review of clinicalmanifestations and management. Viruses. 2022;14(2):192.
8. Zhou J, Li J, Ma L, Cao S. Zoster sine herpete: a review. Korean JPain. 2020;33(3):208-215.
9. Tyring SK, Beutner KR, Tucker BA, Anderson WC, Crooks RJ.Antiviral therapy for herpes zoster: randomized, controlledclinical trial of valacyclovir and famciclovir therapy inimmunocompetent patients 50 years and older. Arch Fam Med.2000;9(9):863.
10. McDonald EM, de Kock J, Ram FS. Antivirals for managementof herpes zoster including ophthalmicus: a systematic reviewof high-quality randomized controlled trials. Antiviral Ther.2012;17(2):255-264.
11. Lin W, Lin H, Lee S, et al. Comparative study of the efficacy andsafety of valaciclovir versus acyclovir in the treatment of herpeszoster. J Microbiol Immunol Infect= Wei Mian yu gan ran za zhi.2001;34(2):138-142.
12. Gershon AA, Breuer J, Cohen JI, et al. Varicella zoster virusinfection. Nature Rev Dis Primers. 2015;1(1):1-18.
13. Whitley RJ, Weiss H, Gnann Jr JW, et al. Acyclovir withand without prednisone for the treatment of herpes zoster:a randomized, placebo-controlled trial. Ann Internal Med.1996;125(5):376-383.
14. Han Y, Zhang J, Chen N, He L, Zhou M, Zhu C. Corticosteroidsfor preventing postherpetic neuralgia. Cochrane DatabaseSystematic Rev. 2013;3:1-33.
15. Forbes HJ, Bhaskaran K, Thomas SL, Smeeth L, Clayton T, LanganSM. Quantification of risk factors for herpes zoster: populationbased case-control study. BMJ. 2014;348:g2911. doi.org/10.1136/bmj.g2911
16. Chen JJ, Zhu Z, Gershon AA, Gershon MD. Mannose6-phosphate receptor dependence of varicella zoster virusinfection in vitro and in the epidermis during varicella and zoster.Cell. 2004;119(7):915-926.
17. Yang Y, Mahmood T, Siddiqui AH, Aziz MA. Zoster sine herpete:two unusual cases of varicella-zoster reactivation with atypicalcomplaints of acute chest pain and severe headache. BMC InfectDis. 2023;23(1):239. doi:10.1186/s12879-023-08093-3
18. Drago F, Herzum A, Ciccarese G, Broccolo F, Rebora A, Parodi A.Acute pain and postherpetic neuralgia related to Varicella zostervirus reactivation: comparison between typical herpes zoster andzoster sine herpete. J Med Virol. 2019;91(2):287-295.
19. Chen WH, Chui C, Yin HL. Zoster sine herpete, vertebralartery stenosis, and ischemic stroke. J Stroke Cerebrovasc Dis.2013;22(7):e234-e237.
20. Ibraheem M, Marin M, Leung J, et al. Fatal wild-type varicella-zoster virus encephalitis without a rash in a vaccinated child.Pediatr Infect Dis J. 2013;32(2):183-185.
Article available in :
Volume 4, Issue 6, 2023
Page : 715-717
https://doi.org/10.47582/jompac.1398243
Article Information
Received : 30 Kas 2023
Accepted : 25 Ara 2023
Published : 31 Ara 2023
Corresponding Author :

Rıdvan Erdin: Department of Internal Medicine, Abant İzzet Baysal University Hospital, Bolu, Turkey

[email protected]
Citation : Erdin R, Soysal BA, Dilcan M. Zona zoster; an atypical presentation with severe pre-lesion pain: a case report. J Med Palliat Care. 2023;4(5):715-717.

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