Intestinal pseudo-obstruction caused by herpes zoster: Case report and pathophysiology

Area of Science:

• Gastroenterology
• Neurology
• Infectious Diseases

Background:

• Herpes zoster (HZ), a viral infection, can lead to various neuropathic complications.
• Visceral neuropathies from HZ can affect the urinary tract and gastrointestinal system.
• Colonic pseudo-obstruction is a recognized, albeit less common, manifestation of HZ-related visceral neuropathy.

Observation:

• A 62-year-old male presented with abdominal distention and a characteristic unilateral vesicular rash.
• Imaging revealed small bowel distention, indicative of an obstructive process.
• The patient's symptoms were attributed to segmental paresis of the small intestine.

Findings:

• The patient was diagnosed with intestinal pseudo-obstruction secondary to HZ-induced visceral neuropathy.
• Conservative management, including bowel rest and supportive care, led to a successful outcome.
• No surgical intervention was required due to prompt diagnosis and management.

Implications:

• Intestinal pseudo-obstruction should be considered in the differential diagnosis of non-obstructive digestive tract conditions in HZ patients.
• Early identification of HZ-related intestinal pseudo-obstruction can prevent unnecessary surgical interventions.
• This case highlights the diverse neurological manifestations of herpes zoster infection.