COVID-19 and herpes zoster co-infection presenting with trigeminal neuropathy
COVID-19 and herpes zoster co-infection presenting with trigeminal neuropathy
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DOI：
10.1111/ene.14361
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发表时间：
2020-09-01
影响因子：
5.1
通讯作者：
Nascimento, O. J. M.
中科院分区：
文献类型：
--
作者：
Ferreira, A. C. A. de F.;Romao, T. T.;Nascimento, O. J. M.
水痘带状疱疹病毒（VZV）是一种人类嗜神经病毒，原发感染后在整个神经轴的神经节神经元内保持潜伏状态。当带状疱疹（HZ）导致三叉神经受累时，眼科是最受牵连的。COVID-19已成为过去几个月在世界各地蔓延的严重急性呼吸系统综合征的病毒病因。已报告了COVID-19和其他病毒的合并感染，但较少，并且涉及呼吸道病毒。方法报告1例新冠病毒合并VZV感染病例，并进行文献复习。结果39岁男性患者新冠肺炎少症状感染，发展为左面部HZ，累及三叉神经三段。合并感染是远程登记的，是呼吸道病毒，尤其是流感，这是最常被引用的关联。然而，本病例说明了潜伏病毒感染的出现，这可能是对前病原体（COVID-19）的炎症反应所促进的。这种反应从鼻腔上升，那里也有三叉分支。结论在这一罕见病例中出现潜伏性VZV感染可能说明了COVID-19的影响，至少是局部影响。这种病毒可能在年轻的免疫功能正常的病人中诱导VZV逆行再激活。
BackgroundVaricella-zoster virus (VZV) is a human neurotropic virus that remains in a latent state within ganglionic neurons throughout the entire neuroaxis after the primary infection. When herpes zoster (HZ) leads to trigeminal involvement, the ophthalmic division is the most implicated. COVID-19 has emerged as a viral cause of severe acute respiratory syndrome that has spread all over the world in the last months. Co-infection with COVID-19 and other viruses has been reported, but sparsely, and involving the respiratory viruses.MethodsThe case of a co-infection of COVID-19 with VZV is reported, and the literature reviewed.ResultsA 39-year-old immunocompetent man presented with oligosymptomatic infection with COVID-19, which evolved to left facial HZ, affecting the three divisions of the trigeminal nerve. The co-infection was remotely registered, being the respiratory viruses, especially influenza, the most commonly cited association. However, the present case illustrates the emergence of a latent virus infection, which might be favored by the inflammatory response to the former agent (COVID-19). This reaction ascended from the nasal cavity, where trigeminal branches are also placed.ConclusionsThe emergence of latent VZV infection in this rare presentation might illustrate an effect, at least locally, of COVID-19. This virus possibly induced a retrograde reactivation of VZV in a young immunocompetent patient.