Simultaneous VZV and HSV-1 Reactivation after Minor Head Injury
  • Romina Häfelfinger
    Division of Internal Medicine, University Hospital Basel, Switzerland and University of Basel, Switzerland
  • Anne-Valérie Burgener
    Division of Internal Medicine, University Hospital Basel, Switzerland and University of Basel, Switzerland
  • Michael Osthoff
    Division of Internal Medicine, University Hospital Basel, Switzerland and University of Basel, Switzerland
  • Eliska Potlukova
    Division of Internal Medicine, University Hospital Basel, Switzerland and University of Basel, Switzerland

Keywords

Herpes simplex virus, varicella zoster virus, head trauma

Abstract

An 81-year-old patient presented to the emergency department with a dark lesion on his forehead and swelling of his left eye, 3 days after a minor forehead injury and skin laceration. He also showed singular papules on his chin, upper chest, upper arms and back, later evolving into vesicles. Polymerase-chain reaction testing of vesicle content was positive for VZV and HSV-1, confirming a diagnosis of disseminated cutaneous herpes virus infection and concomitant HSV-1 reactivation. Antiviral and antibiotic treatment was initiated for 1 week with an immediate response. This case report highlights the association of head trauma and subsequent reactivation of VZV in patients at risk. Simultaneous reactivation of HSV-1 and VZV is rare in immunocompetent patients.

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References

  • Theil D, Derfuss T, Strupp M, Gilden DH, Arbusow V, Brandt T. Cranial nerve palsies: herpes simplex virus type 1 and varizella-zoster virus latency. Ann Neurol 2002;51(2):273–274.
  • Petrun B, Williams V, Brice S. Disseminated varicella-zoster virus in an immunocompetent adult. Dermatol Online J 2015;21(3).
  • Saag M. The Sanford Guide to Antimicrobial Therapy. Sperryville, VA: Antimicrobial Therapy Inc.; 2020.
  • Drone E, Ganti L. A case of disseminated zoster in an immunocompetent patient. Cureus 2019;11(12):e6286.
  • Zhang JX, Joesoef RM, Bialek S, Wang C, Harpaz R. Association of physical trauma with risk of herpes zoster among Medicare beneficiaries in the United States. J Infect Dis 2013;207(6):1007–1011.
  • Uchida K, Teske N, Christensen J. Disseminated zoster after trauma in an immunocompetent patient. Am J Med 2017;130(12):e539–e540.
  • Johnson RW, Levin MJ. Herpes zoster and its prevention by vaccination. Interdiscip Top Gerontol Geriatr 2020;43:131–145.
  • Giehl KA, Müller-Sander E, Rottenkolber M, Degitz K, Volkenandt M, Berking C. Identification and characterization of 20 immunocompetent patients with simultaneous varicella zoster and herpes simplex virus infection. J Eur Acad Dermatol Venereol2008;22(6):722–728.

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    Published: 2020-09-21
    Issue: 2020: Vol 7 No 12 (view)

    How to cite:
    1.
    Häfelfinger R, Burgener A-V, Osthoff M, Potlukova E. Simultaneous VZV and HSV-1 Reactivation after Minor Head Injury. EJCRIM 2020;7 doi:10.12890/2020_001746.