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ARTICLES
Year : 1973  |  Volume : 21  |  Issue : 2  |  Page : 92-93

Herpes zoster ophthalmicus and varicella (a case report)


Department of Ophthalmology, Maulana Azad Medical College and Associated Irwin and G. B. Pant Hospital, New Delhi, India

Correspondence Address:
S.R.K Malik
Department of Ophthalmology, Maulana Azad Medical College and Associated Irwin and G. B. Pant Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


PMID: 4545230

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How to cite this article:
Malik S, Bansal R K. Herpes zoster ophthalmicus and varicella (a case report). Indian J Ophthalmol 1973;21:92-3

How to cite this URL:
Malik S, Bansal R K. Herpes zoster ophthalmicus and varicella (a case report). Indian J Ophthalmol [serial online] 1973 [cited 2020 May 28];21:92-3. Available from: http://www.ijo.in/text.asp?1973/21/2/92/31415

There is considerable evidence which suggests that Herpes zoster and varicella are caused by the same viral agent. The histologic appearance of the cutaneous lesions are similar - THYGESON. [6] Both can be grown in human embryo tissue culture or human thyroid tissue culture - DUKE ELDER. [1] Elementary bodies thought to represent the virus, collected from vesicles of both diseases cannot be differentiated by electron microscopy RAKE. [5] Serum from patients convalesc­ing from varicella will agglutinate virus obtained from Herpes zoster lesions and vice versa.

The common etiology clarifies the epidemiologic relationship of the two diseases. The clinical manifestation of infection with the virus is however influenced by age at which the infec­tion occurs. In adults, it commonly manifests itself as herpes zoster, very uncommonly as varicella. The oppo­site is true of children, who rarely develop herpes zoster. Even more rare is the occurrence of the two condi­tions in the same individual. Only few authors have reported generalized varicella in case of Herpes zoster - FORSIUS, [2] VERNIER AND FOUCHE, [7] GLOTZER, [4] and GARRETT. [3] The purpose of this communication is to report a similar case where generalized chicken pox developed in a case of Herpes zoster.

Further support to the common etiology is in the fact that in a house bearing a case of herpes zoster, the children in the flat get chicken-pox in a matter of days.


  Case Report Top


B. K. G. 59 M was admitted with the complaints of pain around left temporal region, swelling of that region and pain around left eye for last 7 days. A rash along the frontoparietal region was noticed 2 days later. Tip of the nose was not involved.

Examination: On the left side, a papillomacular rash was seen in the frontoparietal region with lid oedema. His conjunctiva was congested, and punctate staining of the cornea was positive. Rest of the ocular examina­tion was normal. There was no apparent lesion seen on the right side. The patient was put on oral and local corticosteroids, dihydroergatimine and lotio calamina locally for herpes zoster. Three days after Herpes zoster, he developed generalized maculo­pappular rash all over his trunk and lower limbs and part of the face with centripetal distribution. The patient was diagnosed as a case of varicella.

The patient was advised complete isolation. X-ray skull did not show any intracranial space occupying lesion. The patient responded to the same treatment in 4-5 days. No ocular or general complication was seen.


  Comments Top


Herpes zoster is very closely related to varicella, Recent bacteriological, immunological and histopathological evidences suggest, that the viruses are actually identical and the different manifestations are probably due to different body responses to the infec­tion with the same virus. In adults the disease commonly manifests as zoster and in children as varicella. In the present case both the conditions were manifested in the same individual simultaneously.

 
  References Top

1.
Duke-Elder, S. S.: System of Ophthalmology, Henery Kimpton, Vol. VIII Pt. I, 1965, p. 336.  Back to cited text no. 1
    
2.
Forsius: Cited in ref. 1 p. 342 (1950).   Back to cited text no. 2
    
3.
Garrett, F. E.: Herpes zoster ophthal­micus - a case report, Amer. J. of Ophth. 46: 741 (1958).  Back to cited text no. 3
    
4.
Glotzer: Cited in ref. 1 p. 342 (1952).   Back to cited text no. 4
    
5.
Rake, G.: The relationship of varicella and Herpes Zoster. Electron Microscopic studies, J. Bact., 56: 293 (1948).  Back to cited text no. 5
    
6.
Thygeson, P.: Ocular bacteriology and virology, Lecture notes, 1956, P. 95.  Back to cited text no. 6
    
7.
Verinier and Fouche: Cited in ref. I p. 342.  Back to cited text no. 7
    


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  [Figure - 1], [Figure - 2], [Figure - 3]



 

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