Abstract:

Herpes Zoster is primarily a dermatologic condition, and its gastrointestinal complication is rarely reported. Acute constipation is a very unusual complication of Herpes Zoster. In this case report, we describe a 59-year old male who was admitted with complaints of abdominal distension and severe constipation for five days, accompanied by multiple itchy vesicular eruptions in the area of T7-T12 dermatomes for four days. The patient was diagnosed with visceral neuropathy leading to acute constipation due to Herpes Zoster. He was managed conservatively with antiviral medication and laxatives and showed dramatic improvement in his symptoms. Early recognition of this complication of Herpes Zoster is very important because timely diagnosis can result in preferable outcome with conservative treatment only, thus avoiding unnecessary surgical intervention.

References:

[1]. Tribble DR, Church P, Frame JN. Gastrointestinal visceral motor complications of dermatomal herpes zoster: report of two cases and review. Clin Infect Dis. Sep 1993;17(3):431-6.

[2]. Maeda K, Furukawa K, Sanada M, Kawai H, Yasuda H. Constipation and segmental abdominal paresis followed by herpes zoster. Intern Med 2007;46:1487-1488.

[3]. Rodrigues G, Kannaiyan L, Gopasetty M, Rao S, Shenoy R. Colonic pseudo-obstruction due to herpes zoster. Indian J Gastroenterol 2002;21:203-204

[4]. Siakir M, Anastasia M, Hakan N, Konstantinos M. Acute constipation due to abdominal herpes zoster: an unusual association. Annals of Gastroenterology. 2012;25:374–375.

[5]. Pui JC1, Furth EE, Minda J, Montone KT, Demonstration of varicella-zoster virus infection in the muscularis propria and myenteric plexi of the colon in an HIV-positive patient with herpes zoster and small bowel pseudo-obstruction (Ogilvie's syndrome), Am J Gastroenterol. 2001 May;96(5):1627-30.

[6]. L. M. Cohen, J. F. Fowler, L. G. Owen, and J. P. Callen, “Urinary retention associated with herpes zoster infection,” International Journal of Dermatology, 1993, vol. 32, no. 1, pp. 24–26.

[7]. Chen PH, Hsueh HF, Hong CZ. Herpes zoster-associated voiding dysfunction: a retrospective study and literature review. Arch Phys Med Rehabil. 2002;83(11):1624–8

[8]. Kim ED, Kang BG, Kim JH, Roh M, Jo DH. Korean J Anesthesiol. 2013 Dec;65(6 Suppl):S143-4. doi: 10.4097/kjae.2013.65.6S.S143.

[9]. Kleinschmidt-DeMasters BK, Gilden DH, Varicella-Zoster virus infections of the nervous system: clinical and pathologic correlates, Arch Pathol Lab Med. 2001 Jun; 125(6):770-80.