Abstract
Herpes Zoster is reactivation of VZV infection, triggered by stress, surgical intervention or lack of the immunocompetency. This intraganglionar latent viral RNA reactivation precede the viral migration trough the neural axons up to the associated dermatome cosing ballonic cell degeneration, multinuclear cell expression with intranuclear inclusions, sumultaneous inflammatory local reaction, finally expressed with characteristic shingles vesicles.
Material and methods: In a six year long period (2004-2010), 52 patients with shingles were hospitalized, 19 (36%) were immunocompromised due to immunosuppressive therapy, lymph reticular malignant illness, HIV infection; 23 (44.4%) patients with shingles had LRT inflammation sings.
Results: Based on the clinical symptoms and standard blood, biochemical, radiological, bacteriological, serological testing's parallel bacterial LRT inflammation was proven among 20 of 23patients (86.9%), or 38.46% of 53 patients. This group of 20 with LRT bacterial inflammation includes 9 immunocompromised (45%) and 11 immunocompetent (55%) patients. Severe pulmonary inflammation had 6 (66.6%) of 9 immunocompromised (one of them nosocomial, transferred from the haematology clinic) and 5 (45.4%) of 11 immunocompetent, or 6 (30%) of 20 and 5 of 20 (25%).
Conclusions: The severity of the dermal expression as well as LRT inflammation was evident among immunocompromised patients. Their hospital treatment was prolonged, from 17days up to 7 weeks (average 23 days) compared to immunocompetent patients with shingles and LRT inflammation (11-27 days-average 14 days). Antimicrobial (antibiotic/antiviral) therapy bas empirically installed from the very beginning of hospital treatment, additionally improved where needed.
- © 2011 ERS
