COVID-19 Re-Enfekte Hastada Periorbital Herpes Zoster Duplex Bilateralis Birlikteliği

Amaç: Varicella-zoster virüsü (VZV) bir insan nörotrofik virüsüdür ve Herpes Zoster (HZ), önceden geçirilmiş bir suçiçeği enfeksiyonunu takiben VZV’nin dorsal kök gangliyonundaki latent durumundan yeniden aktive olduğunda ortaya çıkan bir enfeksiyondur. COVID-19 enfeksiyonunda yaygın ürtiker, suçiçeği benzeri papülo veziküler erüpsiyon, vaskülitik lezyonlar ve HZ gibi çeşitli deri bulgularına rastlandığı da gözlenmiştir. Bitişik olmayan iki dermatom tutulduğunda, tek taraflı etkilenirse herpes zoster duplex unilateralis; iki taraflı ise, bilateralis olarak adlandırılır. Olgu: 39 yaşında kadın hasta, yüksek ateş, halsizlik, öksürük, nefes darlığı ve her iki göz kapağında oluşan döküntüler nedeniyle kliniğimize başvurdu. Hastanın anamnezinden üç ay önce COVID-19 enfeksiyonu ve eşzamanlı olarak yüz felci geçirdiği öğrenildi. Dermatolojik muayenesi sonucunda iki taraflı üst göz kapağında yer alan eritemli zeminde grupe veziküler lezyonların HZ duplex bilateralis ile uyumlu olduğu düşünüldü. 14. Gün sonunda COVID-19 enfeksiyon bulgularının kaybolması ve deri lezyonlarının tamamen iyileşmesi üzerine hasta taburcu edildi. Sonuç: Olgumuz immunkompetan olmasına rağmen ikinci kez COVID-19 enfeksiyonu geçirirken üst göz kapaklarında HZ duplex bilateralis tanısı alması nedeniyle dikkat çekicidir. COVID-19 enfeksiyonu ile HZ dupleks bilateralis birlikteliği şimdiye kadar literatürde bildirilmemiştir. COVID -19 ile enfekte hastalarda HZ enfeksiyonunun sıradışı tutulumlar ile ortaya çıkabileceği göz ardı edilmemelidir.

Co-Infection of Periorbital Herpes Zoster Duplex Bilateralis in COVID-19 Re-Infected Patient

Aim: Varicella-zoster computer virus (VZV) is a human neurotrophic computer and Herpes Zoster (HZ) is a retargeted selection from potential target in the dorsal root ganglion of a bred varicella VZV. Urticaria, which becomes common when COVID-19 grows, has been observed where papule-vesicular eruptions such as chicken pox and days appearing as HZ are observed. Unilateral herpes zoster duplex unilateralis when in two non-adjacent dermatomes; If it is bilateral, it is called bilateral. Case: A 39-year-old female patient was admitted to our clinic with high fever, weakness, cough, shortness of breath and rash on both eyelids. It was learned from the patient’s anamnesis that he had COVID-19 infection and simultaneous facial paralysis three months ago. As a result of the dermatological examination, it was thought that grouped vesicular lesions on the erythematous background on the bilateral upper eyelid were compatible with HZ duplex bilateralis. At the end of the 14th day, the patient was discharged after the signs of COVID-19 infection disappeared and the skin lesions healed completely. Conclusion: Although our case was immunocompetent, it is noteworthy that she was diagnosed with HZ duplex bilateralis on the upper eyelids while she was infected with COVID 19 for the second time. The coexistence of COVID 19 infection and HZ duplex bilateralis has not been reported in the literature so far. It should not be ignored that HZ infection may occur with unusual involvements in patients infected with COVID-19.

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