Herpes zoster with complications in elderly patients





Herpes Zoster; Varicella Zoster Virus; Aging; Geriatrics; Neuralgia.


Herpes Zoster (HZ) is an acute infection caused by the varicella-zoster virus, when it reactivates latent in nerve cells of individuals who have had chickenpox. The mechanism of viral reactivation is still unknown, but it is believed to be related to some type of immunity deficiency. The disease most commonly affects immunosuppressed and elderly individuals. Clinically, it is characterized by vesiculobullous lesions distributed in the region innervated by the affected nerve, causing severe pain. This article reports two cases in elderly patients who complained of oral and cutaneous lesions with painful symptoms. In both cases the lesions involved the trigeminal nerve, with hearing impairment. The cases evolved with complications such as Postherpetic Neuralgia and Ramsay Hunt Syndrome. Antiviral, analgesic, antibiotic and laser therapy were prescribed. In none of the cases there was a recurrence within the 3-year follow-up period. Dental surgeons need to be aware of vesicular lesions - bullous that affect the skin and mucous membranes unilaterally, accompanied by symptoms of itching and pain, especially in the elderly, as they are at increased risk of developing HZ with complications and need for hospitalization.


Almeida, U. T. F. H., Silva, R. A., Almeida, A. H., & Nunes, L. M. A. (2020). Síndrome de Ramsay Hunt: uma revisão sistemática. REAS/EJCH, 55, e3899.

Arruda, J. A. A., Radnai, J. L. P. B., Silva, L. V. O., Souza Neta, I. F., Figueiredo, E. L., Alvares, P. R., & Silveira, M. M. F. (2016). Zoster with Trigeminal Nerve Damage: Case Report. Rev. cir. traumatol. buco-maxilo-fac, 16 (4)

Arwin, A. M. (1996). Varicella-zoster virus. Clin. Microbiol.,9(3)361-381.

Ghaznawi, N. et al. (2011). Herpes zoster ophthalmicus: Comparison of disease in patients 60 years and older versus younger than 60 years. Ophthalmology, 118(11), 2242-2250.

Guimarães F. et al. (2021). How to identify a oral manifestation of Herpes-Zoster? Research, Society and Development,10(2), e31610212617, 2021.

Gupta, S., Gupta S., Thomas, M., Mahendra, A., Jindal, N., Bhaskar, G., & Aggarwal, M. (2013). Herpes Zoster with disseminated lesions. What is it? J Med Life, 6(1), 84-5.

IBGE. Brasil. Censo demográfico. 2018

Lasserre, A., Blaizeau, F., Gorwood, P., Bloch, K., Chauvin, P., Liard, F., Blanchon, T., & Hanslik, T. (2012). Herpes zoster: family history and psychological stress-case-control study. J Clin Virol, 55(2),153-7.

Levin, M. J. (2012). Immune senescence and vaccines to prevent herpes zoster in older persons. Curr Opin Immunol. 24(4), 494-500.

Ludke, M., & Andre, M. E. D. A. (2013). Pesquisas em educação: uma abordagem qualitativa. São Paulo: E.P.U

Mareque, M., Oyagüez I., Morano, R., & Casado, M. A. (2019). Systematic review of the evidence on the epidemiology of herpes zoster: incidence in the general population and specific subpopulations in Spain. Public Health.167, 136‐46.

Khan, Y. M. T., & Fatema, N. (2019). Ramsay Hunt syndrome. Pan Afr Med J. 16 (34), 201.

Kennedy, P. G. E., Graner, M. W., Gunaydin, D., Bowlin, J., Pointon, T., & Yu, X. (2020). Varicella-Zoster Virus infected human neurons are resistant to apoptosis. J Neurovirol. 26, 330-337.

Koche, J. C. (2011). Fundamentos de metodologia científica. Petrópolis: Vozes. Disponível em: http://www.brunovivas.com/wp-content/uploads/sites/10/2018/07/K%C3%B6che-Jos%C3%A9-Carlos0D0AFundamentos-de-metodologia-cient%C3%ADfica-_-teoria-da0D0Aci% C3 %AA ncia-e-inicia%C3%A7%C3%A3o-%C3%A0-pesquisa.pdfhttps://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesq uisa-Cien tifica.p df?sequence=1

Koshy, E., Mengting, L., Kumar H, & Jianbo, W. (2018). Epidemiology, treatment and prevention of herpes zoster: A comprehensive review. Indian J Dermatol Venereol Leprol. 84 (3), 251-262.

Pentikis, H. S., Matson, M., Atiee, G., Boehlecke, B., Hutchins, J. T., Patti, J. M., et al. (2011). Pharmacokinetics and safety of FV‑100, a novel oral anti‑herpes zoster nucleoside analogue, administered in single and multiple doses to healthy young adult and elderly adult volunteers. Antimicrob Agents Chemother. 55, 2847‑54.

Pivovar, L., Cossul, M. F., Melo, J. R., Gil F. B. D., & Lima, A. A. S. Herpes-zóster com manifestação bucal em paciente imunossuprimido: relato de caso. Archives of Oral Research. 9 (2),135-140.

Prest, V. T., Melo, R. B., Sá, C. D. L., Carneiro, N. C. M., Bernardino, R. de S., & Feitosa, V. P. (2021). Clinical report of rare manifestation of Herpes Zoster in the mandibular nerve. Research, Society and Development,.10 (4), e46010414225.

Soyuncu, S., Berk, Y., Eken, C., Gulen, B., & Oktay, C. (2009). Herpes zoster as a useful clinical marker of underlying cell-mediated immune disorders. Ann Acad Med Singapore, 38, 136-138.

Spátola, A. (2010). Neuralgia pós-herpética – tratamento da dor neuropática com uso da toxina botulínica tipo A – apresentação de um caso. Med Reabil, 29(3),74-5.

Studahl, M., Petzold, M., & Cassel, T. (2013). Disease burden of herpes zoster in Sweden--predominance in the elderly and in women - a register based study. BMC Infect Dis, 13(1), 586.

Tseng, H. F., Chi, M., Smith, N., Marcy, S. M., Sy, L. S., & Jacobsen, S. J. (2012). J Infect Dis, 206, 190-6.



How to Cite

BARROS, M. S. .; BENÍCIO, J. A. .; COSTA, L. J. da .; BONAN, P. R. F. .; SILVA, D. F. .; ALBUQUERQUE, A. C. L. de .; SOARES, M. S. M. . Herpes zoster with complications in elderly patients. Research, Society and Development, [S. l.], v. 10, n. 10, p. e208101018654, 2021. DOI: 10.33448/rsd-v10i10.18654. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/18654. Acesso em: 27 oct. 2021.



Health Sciences