Clinical Management of Herpes Zoster Complicated by MRSA Infection

A 59-year-old male presented with a 10-day history of erythematous vesicular lesions on the left chest and shoulder, accompanied by pain in the back. Clinical examination revealed grouped vesicles with some ulceration and exudate, leading to a diagnosis of herpes zoster. After a clear diagnosis, antiviral treatment with valacyclovir and pain relief with pregabalin was administered. Apply povidone-iodine and normal saline (in a 1:10 ratio) externally, once a day, for 30 minutes each time. One week later, the lesions developed ulcers and crusts, with increased exudate; cultures yielded a significant growth of Methicillin-resistant Staphylococcus aureus(MRSA). Based on the drug sensitivity results, cefuroxime combined with levofloxacin was administered for anti-infection treatment. Following two weeks of treatment, the patient showed significant clinical improvement. The patient's rashes have significantly subsided, the ulcers have healed and scabbed over, and the exudation has noticeably decreased. Herpes zoster combined with MRSA infection makes the treatment more complicated. This case illustrates the complexities of managing herpes zoster with MRSA and highlights the importance of comprehensive diagnostic and treatment strategies.