Herpes Zoster eruption post trauma - a case history
We read the article describing the case-control study related to the effect of a mechanical trauma and the eruption of herpes zoster rash (1). Few weeks later a patient was examined at our clinic. We found this patient's case history as representative to that issue.
Mr. M, a 51 year old man, previously healthy, was injured during his work as a trailer driver. He fell down from the height of 4m'. As a result of a contusion to his chest wall two ribs (9-10) were fractured.
Nineteen days later he returned to the practice, complaining on severe pain, unrelated to movement or respiration. Beside slight tenderness over the injured area, no other sign was revealed in physical examination. In his next visit, two days later a rash in the vicinity of the injured area was clearly seen and diagnosed as herpes zoster along the corresponding dermatomes.
Five days later he noticed a bulge noticed in his abdominal muscle, in the contused side. A traumatic hernia was diagnosed as most probably due to a partial tear in the oblique muscle (inserted in 9-10 ribs). He was treated with analgesic and rest.
In our 15 year experience in the practice we have diagnosed herpes zoster several times and cared for patients with trauma quite as often. It is the first time we can point out on direct relationship between both, as it was followed prospectively from the time of the trauma. We assume that what makes the relationship strong is the severity of the trauma.
Competing interests:
None declared
Editorial note The patient whose case is described has given his signed informed consent to publication.
Competing interests:
No competing interests
18 June 2004
Sophia Eilat-Tsanani
M.D Lecturer, Director of Migdal Ha'Emek Health Center
Kadosh Sh. M.D. , Department of Family Medicine, Ha'Emek Medical Center
Department of Family Medicine, Ha'Emek Medical Center. Afula, Israel
Rapid Response:
Herpes Zoster eruption post trauma - a case history
We read the article describing the case-control study related to the effect of a mechanical trauma and the eruption of herpes zoster rash (1). Few weeks later a patient was examined at our clinic. We found this patient's case history as representative to that issue.
Mr. M, a 51 year old man, previously healthy, was injured during his work as a trailer driver. He fell down from the height of 4m'. As a result of a contusion to his chest wall two ribs (9-10) were fractured.
Nineteen days later he returned to the practice, complaining on severe pain, unrelated to movement or respiration. Beside slight tenderness over the injured area, no other sign was revealed in physical examination. In his next visit, two days later a rash in the vicinity of the injured area was clearly seen and diagnosed as herpes zoster along the corresponding dermatomes.
Five days later he noticed a bulge noticed in his abdominal muscle, in the contused side. A traumatic hernia was diagnosed as most probably due to a partial tear in the oblique muscle (inserted in 9-10 ribs). He was treated with analgesic and rest.
In our 15 year experience in the practice we have diagnosed herpes zoster several times and cared for patients with trauma quite as often. It is the first time we can point out on direct relationship between both, as it was followed prospectively from the time of the trauma. We assume that what makes the relationship strong is the severity of the trauma.
Competing interests:
None declared
Editorial note
The patient whose case is described has given his signed informed consent to publication.
Competing interests: No competing interests