Infect Chemother.  2015 Jun;47(2):133-136. 10.3947/ic.2015.47.2.133.

Sacral Herpes Zoster Associated with Voiding Dysfunction in a Young Patient with Scrub Typhus

• Hur J

• KMID: 2069001
• DOI: http://doi.org/10.3947/ic.2015.47.2.133

Abstract

When a patient presents with acute voiding dysfunction without a typical skin rash, it may be difficult to make a diagnosis of herpes zoster. Here, we present a case of scrub typhus in a 25-year-old man with the complication of urinary dysfunction. The patient complained of loss of urinary voiding sensation and constipation. After eight days, he had typical herpes zoster eruptions on the sacral dermatomes and hypalgesia of the S1-S5 dermatomes. No cases of dual infection with varicella zoster virus and Orientia tsutsugamushi were found in the literature. In the described case, scrub typhus probably induced sufficient stress to reactivate the varicella zoster virus. Early recognition of this problem is imperative for prompt and appropriate management, as misdiagnosis can lead to long-term urinary dysfunction. It is important that a diagnosis of herpes zoster be considered, especially in patients with sudden onset urinary retention.

Keyword

Herpes zoster; Scrub typhus; Urinary retention

MeSH Terms

Adult
Constipation
Diagnosis
Diagnostic Errors
Exanthema
Herpes Zoster*
Herpesvirus 3, Human
Humans
Orientia tsutsugamushi
Scrub Typhus*
Sensation
Urinary Retention

Figure

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  Figure 1 Eschar in right flank.

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  Figure 2 Patient with Herpes zoster affecting the both S1-S5 dermatomes.

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