Related Experiment Videos
Disseminated zoster in an elderly patient.
1Internal Medicine Dept, Tenon Hospital, Paris University, France.
Infection
|January 27, 2009
Summary
A disseminated zoster infection, a rare complication of varicella-zoster virus (VZV), occurred in a 97-year-old woman. Despite no signs of immunodeficiency, she developed widespread VZV rash after initial localized shingles.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Dermatology
Background:
- A 97-year-old female patient with hypertension and congestive heart failure was admitted for cellulitis.
- The patient had no known history of immunodeficiency or malignancy.
Observation:
- During hospitalization, the patient developed a painless vesicular rash on the left trigeminal nerve (V1).
- The rash progressed to pustules and crusts, followed by a disseminated chickenpox-like eruption within 4 days.
Findings:
- Polymerase chain reaction (PCR) analysis of a vesicle confirmed varicella-zoster virus (VZV).
- The patient was diagnosed with disseminated zoster, a rare VZV reactivation.
- No underlying immunodeficiency or malignancy was detected through clinical examination, laboratory tests, or chest radiography.
Implications:
- Disseminated zoster can occur in the elderly without apparent immunodeficiency.
- Early diagnosis and antiviral treatment (valacyclovir) are crucial for managing VZV complications.
- This case highlights the importance of considering VZV reactivation in elderly patients presenting with atypical rashes.
Related Concept Videos
01:20Chickenpox
Chickenpox is an acute, highly contagious disease caused by the varicella-zoster virus (VZV), a double-stranded DNA virus belonging to the Herpesviridae family. Its transmission occurs primarily through the inhalation of respiratory droplets or direct contact with vesicular fluid from skin lesions. The incubation period typically ranges from 10 to 21 days, during which the virus replicates and disseminates through sequential phases within the host. Although generally self-limiting in children,...
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...