complications

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  • post-herpetic neuralgia may be seen following herpes zoster infection
    • defined as pain persisting 3 months or more after resolution of the cutaneous HZ lesions.
    • is the most common complication
    • incidence and severity increases with age
  • temporary paralysis (1-5%) usually follows the dermatome involved and may affect bladder and bowel function
  • disseminated HZ occurs primarily in immunocompromised patients; it usually presents with a dermatomal eruption followed by dissemination but may also present with a diffuse varicella-like eruption (1)
    • systemic dissemination may accompany the skin changes with involvement of the lung, liver, and brain
  • visceral dissemination is associated with a mortality rate of 5% to 15%, with most deaths attributable to pneumonia
  • neurologic complications of HZ may include:
    • acute or chronic encephalitis
    • myelitis
    • aseptic meningitis
    • polyradiculitis
    • retinitis
    • autonomic dysfunction
    • motor neuropathies
    • Guillain-Barre syndrome
    • hemiparesis
    • cranial or peripheral nerve palsies
  • more common complications include bacterial superinfection by Staphylococcus aureus or Streptococcus pyogenes, scarring, and hyperpigmentation
    • secondary infection - especially dangerous in the ophthalmic division.

Reference:

Last edited 11/2018 and last reviewed 10/2021

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