Herpes zoster at the NIH: a 20 year experience

Area of Science:

• Infectious Diseases
• Oncology
• Neurology

Background:

• Herpes zoster (shingles) is a viral infection caused by the reactivation of the varicella-zoster virus.
• Understanding risk factors and outcomes in hospitalized populations is crucial for patient management.

Purpose of the Study:

• To review cases of herpes zoster in a hospitalized population over a 20-year period.
• To identify predisposing factors, clinical presentations, and outcomes of herpes zoster in this cohort.

Main Methods:

• Retrospective review of 107 hospitalized patients diagnosed with herpes zoster.
• Analysis of patient demographics, underlying illnesses, zoster characteristics, and predisposing factors.

Main Results:

• Zoster occurred throughout the year, with lymphoproliferative malignancy being the most frequent associated illness.
• Localized zoster was most common in the thoracic region; 15% of cases disseminated, with central nervous system involvement in one-third of these.
• Predisposing factors included local irradiation, surgery, splenectomy (in Hodgkin's disease), and corticosteroid therapy (in disseminated zoster).

Conclusions:

• Herpes zoster in hospitalized patients primarily increases morbidity rather than mortality.
• Multiple factors contribute to zoster development in this population, with lymphoproliferative malignancy being a significant association.