2023-11-04 16:13:05
Title: Rare Case of Spreading Shingles Discovered by Thai Physician
Subtitle: Acyclovir Treatment Proves Effective in Controlling Symptoms
Date: October 22, 2023
Dr. Manoon Leechawengwong, a renowned respiratory system diseases specialist at Vichaiyut Hospital, recently encountered an extraordinary case of spreading shingles in a 50-year-old female patient. This peculiar condition, known as disseminated herpes zoster, is rare and typically affects individuals with compromised immune systems. Symptoms of this condition include the appearance of fever and blisters all over the body.
The patient, who had been in good health, fell ill on October 15, 2023, experiencing symptoms such as severe headaches, body aches, and mouth sores for three consecutive days. Shortly after, water blisters and pustules emerged on her skin, primarily on the earlobes, forehead, chest, neck, back, and thighs. There was no history of direct contact with individuals who had chickenpox. Seeking treatment, she initially visited a nearby hospital on October 19, where she received intravenous acyclovir for two days. Subsequently, she requested a transfer to Vichaiyut Hospital for further care.
Further examination revealed slight anemia and mildly elevated liver enzyme values. Notably, laboratory tests ruled out the presence of the smallpox virus and varicella-zoster virus in the patient’s aspirated fluid and blood. Additionally, the cerebrospinal fluid showed an increased white blood cell count, with lymphocytes accounting for 81% of the total count. However, genetic code PCR testing failed to detect the presence of varicella-zoster virus and herpes simplex viruses type 1 and 2.
Based on the available data, it is highly likely that the patient has been infected with the varicella-zoster virus, commonly known as the shingles virus, which stems from the same virus that causes chickenpox. The condition in this patient led to invasive shingles and meningitis; fortunately, prompt administration of acyclovir significantly improved her symptoms, including fever reduction, headache relief, and improved mouth sores. The pustules have begun to dry up, and, if scabs develop, the patient will continue receiving acyclovir intravenously for 14 days.
It is important to note that Thailand currently offers a highly effective vaccine that effectively prevents all types of shingles. This serves as a crucial reminder for individuals to protect themselves against this viral infection.
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