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Zoster sine herpete: a review.

Junli Zhou1, Juan Li1, Lulin Ma1

  • 1Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

The Korean Journal of Pain
|July 2, 2020
PubMed
Summary

Zoster sine herpete (ZSH) presents with varicella-zoster virus (VZV) reactivation but no rash, complicating diagnosis. Early VZV DNA detection aids in identifying ZSH and preventing severe neurological complications.

Keywords:
Antiviral AgentsDiagnosisHerpes ZosterHerpesvirus 3HumanInfectionsNeuralgiaPostherpeticTherapeuticsVirus DiseasesZoster Sine Herpete.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Zoster sine herpete (ZSH) is an atypical manifestation of herpes zoster (HZ) caused by varicella-zoster virus (VZV) reactivation.
  • ZSH lacks the characteristic rash of HZ, leading to diagnostic challenges.
  • Symptoms include neuralgia, Bell palsy, Ramsay Hunt syndrome, and potentially severe complications like encephalitis and stroke.

Purpose of the Study:

  • To review current literature on Zoster sine herpete (ZSH).
  • To highlight diagnostic methods for ZSH, focusing on VZV DNA and antibody detection.
  • To emphasize the need for further research into ZSH epidemiology and treatment guidelines.

Main Methods:

  • Literature review of publications related to Zoster sine herpete (ZSH).
  • Focus on diagnostic techniques involving VZV DNA and anti-VZV immunoglobulin (IgG and IgM) detection.
  • Analysis of case reports and existing studies on ZSH.

Main Results:

  • ZSH diagnosis is challenging due to the absence of a rash.
  • Neuropathic pain and neurological deficits are common initial symptoms.
  • Delayed diagnosis and treatment can result in severe sequelae, including encephalitis and stroke.

Conclusions:

  • Accurate and timely diagnosis of ZSH is crucial to prevent severe complications.
  • Diagnostic confirmation often relies on detecting VZV DNA and/or specific antibodies.
  • Further epidemiological studies and standardized diagnostic/treatment guidelines for ZSH are necessary.