An Infection that Vaccine Doesn't Prevent over Time

​BY NATALIE CAZEAU, ​MSC; ERICA ROMAN HERNANDEZ; KINZA IJAZ; AMY SCHEUERMANN; AHMED RAZIUDDIN, MDA 43-year-old man presented to the ED with a rash in a C7 dermatomal pattern that was burning and painful. The patient said the rash began three weeks before the ED visit as a group of little blisters on his right upper back and extending down his right arm. The patient was worried and in mild distress as the rash continued to burn, and he reported numbness to the area. He mentioned he had received the shingles vaccine in the past.​The patient's rash was yellow, crusty, and tender upon palpation. The area was hyperkeratotic with noticeable scabbed lesions and cracked skin. The patient had normal range of motion without motor deficits in the right arm. Herpes zoster (HZ) is caused by the reactivation of varicella zoster virus (VZV), which occurs when immunity to VZV declines because of aging and or immunosuppression. This condition most commonly affects the elderly population; more than half of the cases of HZ occur in patients over 60. (Mayo Clin Proc 2009;84[3]:274.) The condition is diagnosed clinically by the distinctive dermatomal characteristics of the rash and the painful sensation. Herpes zoster lesions contain high concentrations of VZV, which can spread through physical contact or airborne transmission. Exposure to airborne VZV can result in primary varicella infection in susceptible people. HZ is only contagious, however, from the time after the rash appea...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research