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Published 28 April 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.07.2008.0525]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Unusual association of diseases/symptoms

Reactivation of herpes zoster along the trigeminal nerve with intractable pain after facial trauma: a case report and literature review

K-C Lin1, Che-Chuan Wang2, Kai-Yuan Wang3, Yi-Chen Liao4, Jinn-Rung Kuo2

1 Chi-Mei Medical Center, Neurology, 901, Jong-Hwa Rd, Tainan, 710, Taiwan
2 Chi-Mei Medical Center, Neurosurgery, 901, Jong-Hwa Rd, Tainan, 710, Taiwan
3 Chi-Mei Medical Center, Emergency Medicine, 901, Jong-Hwa Rd, Tainan, 710, Taiwan
4 Chi-Mei Medical Center, Dermatologist, 901, Jong-Hwa Rd, Tainan, 710, Taiwan

Correspondence to:
Jinn-Rung Kuo, cmh7520{at}mail.chimei.org.tw

SUMMARY

We report the rare occurrence of herpes zoster reactivation after facial trauma. Herpes zoster appeared in painful groups of distended vesicles containing clear fluid on an erythematous base within the secondary division of the trigeminal nerve. The patient was treated with acyclovir (intravenous, 250 mg, every 8 hours) combined with topical steroids and anti-neuropathic pain medication. The zoster-associated neuralgia subsided gradually 1.5 months after diagnosis. We illustrate this unique case to highlight the fact that reactivation of the varicella zoster virus from childhood chicken pox can reappear at a traumatic site in late adulthood.


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