Clinical presentation of herpes zoster in a Singapore hospital

There is a direct correlation between increasing age and incidence of herpes zoster. There is an increased risk of complications in the elderly and the immunocompromised.

To study the clinical epidemiology of hospitalised patients with herpes zoster.

Medical records of all patients hospitalised with zoster were respectively analysed.

Sixty-seven patients (3% of total admissions) were studied. There were 35 males and 32 females with a mean age of 50.35 +/- 21.71. There was an increased proportion of older patients in the study cohort. Nineteen patients (28.4%) were immunocompromised with malignancy occurring in 9 patients. Thirteen had been on cytotoxic and/or steroid therapy. The commonest symptoms were rash, pain and fever. Eighty-five percent of the patients had complications (bacterial super-infection in (61%), dissemination (31%), ocular involvement (5%) and post-herpetic neuralgia (13.4%). There was an increasing frequency of duration of pain with increasing age in the patients with post-herpetic neuralgia. Forty-three patients were treated with acyclovir. The median time to healing of lesions was 11 days. The 41 patients with bacterial super-infection received antibiotics with median time to healing of 12 days.

Increasing age and immunocompromised state appear to be risk factors for developing herpes zoster in hospitalised patients.