Yun G, Kim E, Baik J, Do W, Jung YH, You CM. Diagnosis and management of ophthalmic zoster sine herpete accompanied by cervical spine disc protrusion: A case report. World J Clin Cases 2021; 9(25): 7588-7592 [PMID: 34616830 DOI: 10.12998/wjcc.v9.i25.7588]
Corresponding Author of This Article
Eunsoo Kim, MD, PhD, Associate Professor, Doctor, Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan 49241, South Korea. eunsookim@pusan.ac.kr
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2021; 9(25): 7588-7592 Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7588
Diagnosis and management of ophthalmic zoster sine herpete accompanied by cervical spine disc protrusion: A case report
Giyoung Yun, Eunsoo Kim, Jiseok Baik, Wangseok Do, Young-Hoon Jung, Chang-Min You
Giyoung Yun, Eunsoo Kim, Jiseok Baik, Wangseok Do, Young-Hoon Jung, Chang-Min You, Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
Giyoung Yun, Eunsoo Kim, Department of Anesthesia and Pain Medicine, Pusan National University, School of Medicine, Yangsan 50612, South Korea
Author contributions: Yun G reviewed the literature and contributed to the manuscript; Kim E reviewed the literature and contributed to the manuscript; Do W and Jung YH cared for the patient; You CM reviewed the manuscript; Baik J supervised the work.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eunsoo Kim, MD, PhD, Associate Professor, Doctor, Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan 49241, South Korea. eunsookim@pusan.ac.kr
Received: April 6, 2021 Peer-review started: April 6, 2021 First decision: May 11, 2021 Revised: May 14, 2021 Accepted: July 22, 2021 Article in press: July 22, 2021 Published online: September 6, 2021
Abstract
BACKGROUND
Zoster sine herpete (ZSH) can be misdiagnosed because there are no typical vesicular eruptions characterized by a dermatomal distribution. However, incorrect treatment due to a misdiagnosis can lead to severe pain and fatal complications.
CASE SUMMARY
A 75-year-old woman complained of sudden onset right shoulder pain and atypical headache. After 18 d, sudden hearing loss occurred in the left ear. In serology tests conducted after the onset of hearing loss, varicella-zoster virus IgM was positive. She had no history of a rash or trauma. Under the suspicion of ZSH, antiviral treatment and stellate ganglion block were administered four times, and the pain was effectively controlled.
CONCLUSION
Early diagnosis and treatment of ZSH can help not only by reducing pain but also by preventing fatal complications.
Core Tip: If the development of shingles does not occur in patients with complex underlying diseases, treatment and diagnosis of zoster sine herpete (ZSH) may be delayed. Clinical symptoms are well evaluated when the patient complains of pain. Serological tests should be conducted to provide a basis for the diagnosis of ZSH. It is possible to effectively treat the disease without causing serious complications.
