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Clinical Diagnosis and Treatment of Herpes Zoster in an Immunocompromised Dental Patient: A Case Report

  • Kim, Hyun-Suk (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Ahn, Kyo-Jin (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) ;
  • Kim, Young-Kyun (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital)
  • 투고 : 2014.09.03
  • 심사 : 2014.12.22
  • 발행 : 2014.12.30

초록

Herpes zoster (HZ) is an acute, unilateral inflammatory viral infection characterized by a rash with painful blisters in a localized area of the body. HZ is often associated with intense pain in the acute phase and presents postherpetic neuralgia in the chronic phase. During the prodromal stage of the HZ from the trigeminal nerve, however, the only presenting symptom may be odontalgia, which could be particularly difficult to diagnose. This distinctive syndrome occurs predominantly in the immunocompromised or elderly individuals. In this article, we report a case of HZ developed in the trigeminal nerve of a 60-year-old immunocompromised female patient, whose symptoms including atypical, non-odontogenic odontalgia had improved after series of antiviral treatments.

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참고문헌

  1. Bale JF Jr. Viral encephalitis. Med Clin North Am. 1993; 77: 25-42. https://doi.org/10.1016/S0025-7125(16)30270-X
  2. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002; 347: 340-6. https://doi.org/10.1056/NEJMcp013211
  3. Mueller NH, Gilden DH, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus infection: clinical features, molecular pathogenesis of disease, and latency. Neurol Clin. 2008; 26: 675-97. https://doi.org/10.1016/j.ncl.2008.03.011
  4. Johnson RW, Whitton TL. Management of herpes zoster (shingles) and postherpetic neuralgia. Expert Opin Pharmacother. 2004; 5: 551-9. https://doi.org/10.1517/14656566.5.3.551
  5. Cvjetkovic D, Jovanovic J, Hrnjakovic-Cvjetkovic I, Brkic S, Bogdanovic M. Reactivation of herpes zoster infection by varicella-zoster virus. Med Pregl. 1999; 52: 125-8.
  6. Lydick E, Epstein RS, Himmelberger D, White CJ. Herpes zoster and quality of life: a self-limited disease with severe impact. Neurology. 1995; 45(12 Suppl 8): S52-3. https://doi.org/10.1212/WNL.45.12_Suppl_8.S52
  7. Guttiganur N, Devanoorkar A, Aspalli S, Shetty S. Herpes zoster of trigeminal nerve after dental extraction. Indian J Dent Res. 2013; 24: 396. https://doi.org/10.4103/0970-9290.118011
  8. Millar EP, Troulis MJ. Herpes zoster of the trigeminal nerve: the dentist's role in diagnosis and management. J Can Dent Assoc. 1994; 60: 450-3.
  9. Goon WW, Jacobsen PL. Prodromal odontalgia and multiple devitalized teeth caused by a herpes zoster infection of the trigeminal nerve: report of case. J Am Dent Assoc. 1988; 116: 500-4. https://doi.org/10.14219/jada.archive.1988.0301
  10. Fristad I, Bardsen A, Knudsen GC, Molven O. Prodromal herpes zoster--a diagnostic challenge in endodontics. Int Endod J. 2002; 35: 1012-6. https://doi.org/10.1046/j.1365-2591.2002.00605.x
  11. Harpaz R, Ortega-Sanchez IR, Seward JF; Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC). Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008; 57: 1-30.
  12. Gilden D. Efficacy of live zoster vaccine in preventing zoster and postherpetic neuralgia. J Intern Med. 2011; 269: 496-506. https://doi.org/10.1111/j.1365-2796.2011.02359.x
  13. Whitley RJ, Weiss H, Gnann JW Jr, Tyring S, Mertz GJ, Pappas PG, Schleupner CJ, Hayden F, Wolf J, Soong SJ; The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Acyclovir with and without prednisone for the treatment of herpes zoster: a randomized, placebo-controlled trial. Ann Intern Med. 1996; 125: 376-83. https://doi.org/10.7326/0003-4819-125-5-199609010-00004
  14. Tyring SK. Management of herpes zoster and postherpetic neuralgia. J Am Acad Dermatol. 2007; 57(6 Suppl): S136-42. https://doi.org/10.1016/j.jaad.2007.09.016
  15. Kneebone WJ. Therapeutic laser in the treatment of herpes zoster [Internet]. Montclair (NJ): Vertical Health LLC, Practical Pain Management; 2010 Jan 1 [cited 2014 Sep 3]. Available from: http://www.practicalpainmanagement.com/therapeutic-laser-treatment-herpes-zoster