Diagnosis and management of a Herpes zoster complication: a case report

Abstract

Objective: To report a case of Herpes zoster (HZ) followed by segmental zoster paresis, a complication related to root involvement and axonal damage, and to discuss its management and prevention strategies. Case Detail: 80-year-old male, hypertensive, pre-diabetic and COPD patient attended the consultation complaining of pain in his legs and left hip, without other symptoms. Hip and knee arthrosis have been suspected, but it evolved the next day with lumbosacral and left lower limb injuries with paresthesia, being reevaluated and diagnosed with Herpes Zoster and Postherpetic Neuritis. Valacyclovir and pregabalin were prescribed. 14 days after the onset of the condition, there was a significant loss of limb strength. Herpes Zoster Radiculopathy, a rare complication lasting from weeks to months, was considered. This hypothesis was confirmed in the requested exams. The treatment with physiotherapy was initiated and, after 10 weeks, there was a significant improvement in pain and changes in strength only with great efforts. Conclusion: HZ presents potentially serious and disabling complications. When installed, the need for early diagnosis and treatment is evident. Therefore, the importance of a multidisciplinary segment, such as the early institution of physical therapy, is highlighted.