Anesth Pain Med.  2017 Jan;12(1):77-80. 10.17085/apm.2017.12.1.77.

Intractable postherpetic neuralgia after herpes zoster duplex bilateralis in an immunocompromised patient: A case report

• Lim SH
• Lee KM
• Lee W
• Choi DN
• Lee JH
• Cho K
• Kim MH
• Ki SH
• Kim JH

• KMID: 2369672
• DOI: http://doi.org/10.17085/apm.2017.12.1.77

Abstract

Herpes zoster is caused by the reactivation of the varicella-zoster virus, and it typically presents as single dermatomal rash and vesicles. It can cause postherpetic neuralgia as a common complication. In immunocompromised patients, the lesions can be cutaneous, disseminated into two non-contiguous dermatomes, and this entity is referred to as herpes zoster duplex unilateralis or bilateralis. We present a case of postherpetic neuralgia after herpes zoster duplex bilateralis in a 60-year-old immunocompromised man. He had a past history of acute lymphocytic leukemia and was treated with allogeneic peripheral blood stem cell transplantation 1 year before herpes zoster reactivation. His postherpetic neuralgia pain was difficult to treat and it was refractory to conservative medication and neuraxial block.

Keyword

Herpes zoster duplex bilateralis; Immunocompromised; Postherpetic neuralgia

MeSH Terms

Exanthema
Herpes Zoster*
Herpesvirus 3, Human
Humans
Immunocompromised Host*
Middle Aged
Neuralgia, Postherpetic*
Peripheral Blood Stem Cell Transplantation
Precursor Cell Lymphoblastic Leukemia-Lymphoma

Figure

• 

  Fig. 1 Multiple crusted vesicles and erythema in C2 dermatome on the right side and T7 dermatome on the left side. Patient underwent cervical, thoracic epidural block.

• 

  Fig. 2 Discolored skin after severe herpes zoster rash healed.

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