Herpes zoster ophthalmicus and the immunocompromised host: a case report and review

Herpes zoster is the secondary form of varicella zoster virus disease, caused by the reactivation of the dormant virus in the sensory ganglia. It manifests as a unilateral cutaneous dermatitis with a prodromal fever and malaise. Herpes zoster ophthalmicus occurs when the ophthalmic division of the trigeminal nerve becomes afflicted.

This case represents a middle-aged female with breast carcinoma. Cancer radiotherapy and chemotherapy created an immunosuppressed state, which allowed the development of herpes zoster ophthalmicus. Most patients who manifest zoster are immunocompetent. However, with the increased incidence of immunodeficient states (e.g., chemotherapy, organ transplantation and acquired immunodeficiency syndrome), clinicians are faced with a greater number of cases of zoster. In the immunodeficient population, especially, dissemination of the zoster and potentially damaging complications can occur.

In the light of these facts, clinicians must be well versed in all aspects of herpes zoster disease, including the clinical and laboratory diagnosis, as well as the incidence and presentation of herpes zoster. Current treatments, such as the use of famciclovir, acyclovir, valcyclovir, and prednisone, must also be understood.