• Journal of Yeungnam Medical Science
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• v.33 no.1
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• pp.1-7
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• 2016

The two distinctive clinical features of varicella-zoster virus (VZV) are varicella (chickenpox) by primary infection and zoster (singles) by the reactivation of latent infection. In addition to the two typical clinical symptoms mentioned above, diverse clinical manifestations have been reported as a result of VZV reactivation, including chronic radicular pain without rash, visual loss, facial palsy, dysphagia, sore throat, odynophagia, otalgia, hearing loss, dizziness, headache, hemiplegia, etc. Most of these symptoms are derived from neuropathy and vasculopathy of affected nerves and arteries. Diagnosis of VZV disease can be difficult if there is no appearance of a skin rash during development of atypical symptoms. In addition to natural infection, vaccination and anti-viral agent treatment have influenced the changes of epidemics and clinical presentations of varicella and zoster. In this article, diverse clinical manifestations caused by VZV reactivation, particular without skin rash, are reviewed.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.210-213
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• 2005

Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.

• Pediatric Infection and Vaccine
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• v.29 no.2
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• pp.110-117
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• 2022

Herpes zoster (HZ) has been reported in immunocompetent children who received the varicella vaccine. In vaccinated children, HZ can be caused by vaccine-strain or by wild-type varicella-zoster virus (VZV). Like wild-type VZV, varicella vaccine virus can establish latency and reactivate as HZ. We report two cases of HZ in otherwise healthy 16- and 14-month-old boys who received varicella vaccine at 12 months of age. They presented with a vesicular rash on their upper extremities three to four months after varicella vaccination. In one case, a swab was obtained by abrading skin vesicles and VZV was detected in skin specimens by polymerase chain reaction. The VZV open-reading frame 62 was sequenced and single nucleotide polymorphism analysis confirmed that the virus from skin specimen was vaccine-strain. This is the first HZ case following varicella vaccination confirmed to be caused by vaccine-strain VZV in the immunocompetent children in Korea. Pediatricians should be aware of the potential for varicella vaccine virus reactivation in vaccinated young children.

• KSBB Journal
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• v.9 no.3
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• pp.272-278
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• 1994

Attenuated varicella-zoster virus(VZV) was cultured in human embryonic lung cells. The effects of serum type and its concentration on the production of VZV were studied. Regardless of cell culture conditions, VZV yield was increased with multiplicity of infection, and the total cell concentration was decreased after virus infection. The newborn calf serum, calf serum, or horse serum was not as good as the fetal bovine serum or calf serum supplemented with iron for the propagation of VZV in the human embryonic lung cells. The yields of total VZV(cell-associated virus and cell-free virus) in the medium with calf serum containing iron were comparable to those in the medium supplemented with fetal bovine serum. Furthermore, some components of serum appear to be important for the maintenance of VZV infectivity.

• The Korean Journal of Pain
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• v.36 no.1
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• pp.4-10
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• 2023

Herpes zoster (HZ) is a common disease in the aging population and immunocompromised individuals, with a lifetime risk of 20%-30% that increases with age. HZ is caused by reactivation of the varicella-zoster virus (VZV), which remains latent in the spinal dorsal root ganglia and cranial sensory ganglia after resolution of the primary VZV infection. The main focus of HZ management is rapid recovery from VZV infection as well as the reduction and prevention of zoster-associated pain (ZAP) and postherpetic neuralgia (PHN). The use of antivirals against VZV is essential in the treatment of HZ. However, limited antivirals are only licensed clinically for the treatment of HZ, including acyclovir, valacyclovir, famciclovir, brivudine, and amenamevir. Fortunately, some new antivirals against different types of Herpesviridae have been investigated and suggested as novel drugs against VZV. Therefore, this review focuses on discussing the difference in efficacy and safety in the currently licensed antivirals for the treatment of HZ, the applicability of future novel antivirals against VZV, and the preventive or therapeutic effects of these antivirals on ZAP or PHN.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.222-230
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• 1999

Varicella-zoster virus(VZV) becomes latent in the sensory ganglia after primary infection and emerges from latency to cause zoster in adults. After primary infection, VZV remains latent in the dorsal spinal ganglia. The mechanisms responsible for its reactivation and the clinical entity of herpes zoster are poorly understood. Reactivation of VZV is commonly known to manifest as Ramsay Hunt syndrome which is one of the VZV-associated neurologic diseases with facial paralysis, ear pain, and a characteristic herpetic auricular rash. It is now known that lesions of this syndrome can affect all cranial nerves. Central, cervical and peripheral effects of this syndrome is polyneuropathic in nature. VZV usually involves the 5th and 7th cranial nerves and less commonly the lower cranial nerves such as 9th and 10th. We report a treated case of healthy 40 years old male with VZV infection of the 5th, 9th and 10th cranial nerves. The patient typically showed herpetic vesicles in the auricle and temporal bone area without facial paralysis.

• Journal of Microbiology and Biotechnology
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• v.25 no.2
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• pp.268-273
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• 2015

The fluorescent-antibody-to-membrane-antigen (FAMA) test is regarded as the "gold standard" to detect protective antibodies to varicella-zoster virus (VZV) because of its high sensitivity and specificity. Because the classic FAMA test uses an infectious virus for detection of antibodies to VZV, it is labor-intensive, and also requires special equipment for handling the virus. For this reason, we attempted to develop a simple and safe FAMA assay. Because VZV glycoprotein E (gE) is one of the major VZV glycoproteins, we used the gE protein for the FAMA test (gE FAMA). Here, we demonstrate that overexpression of gE in HEK293T cells can be used to measure antibodies in human serum, and that gE FAMA titers are closely correlated with gpEIA ELISA data. These results indicate that our gE FAMA test has the potential to measure antibodies to VZV.

• Clinical and Experimental Pediatrics
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• v.52 no.6
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• pp.705-709
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• 2009

Herpes zoster is caused by the varicella-zoster virus (VZV), which affects nerve ganglions. VZV infection may be associated with neurologic complications, which are usually observed after vesicular exanthem. Acute aseptic meningitis is a rare complication of VZV reactivation. We report the case of a previously healthy 14-year-old boy who suffered from aseptic meningitis that was attributed to reactivated VZV infection with exanthem; the patient had undergone vaccination against varicella. This condition can be confirmed by the detection of VZV DNA in the cerebrospinal fluid. The patient was treated with acyclovir and recovered fully.

• Natural Product Sciences
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• v.5 no.2
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• pp.107-111
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• 1999

To investigate less toxic antiviral agents from Basidiomycetes, EA, the water soluble substance, was isolated from the carpophores of Elfvingia applanata (pers.) Karst. Anti-varicella zoster virus (Oka strain; anti-VZV/Oka) activity of EA was examined in MRC-5 cells by plaque reduction assay in vitro. And the combined antiviral effects of EA with nucleoside anti-VZV agents, acyclovir and vidarabine, were examined on the multiplication of VZV/Oka. EA exhibited a concentration-dependent reduction in the plaque formation of VZV/Oka with a 50% effective concentration $(EC_{50})$ of $464.14\;{\mu}g/ml$. The results of combination assay were evaluated by the combination index (CI) that was calculated by the multiple drug effect analysis. The combination of EA with acyclovir showed more potent synergism with CI values of $0.18{\sim}0.62$ for $50{\sim}90%$ effective levels than that of EA with vidarabine with CI values of $0.67{\sim}1.04$.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.607-610
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• 2009

Varicella zoster virus (VZV) causes two diseases: Varicella, a generalized, primary infection, and herpes zoster (zoster), a secondary infection caused by latent VZV reactivation. Zoster can also be caused by latent VZV reactivation after a varicella vaccination. The complications associated with varicella include cutaneous infections, which are the most common, as well as pulmonary and neurological involvement. However, a deep venous thrombosis (DVT) has been rarely described as a varicella-associated complication. Here, we describe the case of a child with varicella zoster who developed a DVT that completely resolved after intravenous acyclovir and subcutaneous low-molecular-weight heparin treatment.