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Risk Factors for Aseptic Meningitis in Herpes Zoster Patients

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초록

Background: Herpes zoster (HZ) is caused by reactivation of latent varicella-zoster virus (VZV) infection. HZ-associated aseptic meningitis, a rare complication of HZ, can require hospitalization and a long treatment period. Objective: A retrospective study was performed to identify potential factors associated with HZ-associated aseptic meningitis development. Methods: We included all outpatients and patients admitted in the neurology and dermatology departments of a single tertiary center, who were diagnosed with HZ for two years. Among 818 patients, 578 patients were eligible for analysis. Results: The demographics and potential risk factors were compared between the uncomplicated HZ group (n=554) and aseptic meningitis group (n=24). Among the potential factors, the dermatological distribution of skin rash and gender showed statistically significantly different between the two groups. Patients with craniocervical distribution of HZ accounted for 87.5% (n=21) of the aseptic meningitis group and 54.3% (n=301) of the uncomplicated HZ group (p=0.043). The aseptic meningitis group had more men (66.7%, n=16) than the uncomplicated HZ group (42.8%, n=237, p=0.033). Patients with craniocervical distribution had an odds ratio (OR) of 5.884 (p=0.001) for developing aseptic meningitis when compared with the other dermatome involvements. Additional logistic regression analysis resulted in a fading between gender difference (p=0.050) and craniocervical involvement having an OR of 5.667 for aseptic meningitis (p=0.006). Conclusion: In HZ patients, skin rash with craniocervical distribution and male gender were associated with a higher risk of aseptic meningitis.

Abstract

Background: Herpes zoster (HZ) is caused by reactivation of latent varicella-zoster virus (VZV) infection. HZ-associated aseptic meningitis, a rare complication of HZ, can require hospitalization and a long treatment period. Objective: A retrospective study was performed to identify potential factors associated with HZ-associated aseptic meningitis development. Methods: We included all outpatients and patients admitted in the neurology and dermatology departments of a single tertiary center, who were diagnosed with HZ for two years. Among 818 patients, 578 patients were eligible for analysis. Results: The demographics and potential risk factors were compared between the uncomplicated HZ group (n=554) and aseptic meningitis group (n=24). Among the potential factors, the dermatological distribution of skin rash and gender showed statistically significantly different between the two groups. Patients with craniocervical distribution of HZ accounted for 87.5% (n=21) of the aseptic meningitis group and 54.3% (n=301) of the uncomplicated HZ group (p=0.043). The aseptic meningitis group had more men (66.7%, n=16) than the uncomplicated HZ group (42.8%, n=237, p=0.033). Patients with craniocervical distribution had an odds ratio (OR) of 5.884 (p=0.001) for developing aseptic meningitis when compared with the other dermatome involvements. Additional logistic regression analysis resulted in a fading between gender difference (p=0.050) and craniocervical involvement having an OR of 5.667 for aseptic meningitis (p=0.006). Conclusion: In HZ patients, skin rash with craniocervical distribution and male gender were associated with a higher risk of aseptic meningitis.

참고문헌 (18)

  1. Ku CC, "Tropism of varicella-zoster virus for human tonsillar CD4(+) T lymphocytes that express activation, memory, and skin homing markers", J Virol, 76, pp.11425~11433 (2002)
  2. Chen JJ, "Latent and lytic infection of isolated guinea pig enteric ganglia by varicella zoster virus", J Med Virol, (70 Suppl 1), pp.S71~S78 (2003)
  3. Yawn BP, "A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction", Mayo Clin Proc, 82, pp.1341~1349 (2007)
  4. Gilden DH, "Neurologic complications of the reactivation of varicella-zoster virus", N Engl J Med, 342, pp.635~645 (2000)
  5. Galil K, "The sequelae of herpes zoster", Arch Intern Med, 157, pp.1209~1213 (1997)
  6. Hughes BA, "Herpes zosterassociated meningoencephalitis in patients with systemic cancer", Mayo Clin Proc, 68, pp.652~655 (1993)
  7. Kleinschmidt-Demasters BK, "Profound cerebrospinal fluid pleocytosis and Froin's syndrome secondary to widespread necrotizing vasculitis in an HIV-positive patient with varicella zoster virus encephalomyelitis", J Neurol Sci, 159, pp.213~218 (1998)
  8. Haanpää M, "CSF and MRI findings in patients with acute herpes zoster", Neurology, 51, pp.1405~1411 (1998)
  9. Becerra JC, "Infection of the central nervous system caused by varicella zoster virus reactivation: a retrospective case series study", Int J Infect Dis, 17, pp.e529~e534 (2013)
  10. Studahl M, "Disease burden of herpes zoster in Sweden--predominance in the elderly and in women-a register based study", BMC Infect Dis, 13, pp.586~ (2013)
  11. Pinchinat S, "Similar herpes zoster incidence across Europe: results from a systematic literature review", BMC Infect Dis, 13, pp.170~ (2013)
  12. Antonelli MA, "Herpes zoster in patients with rheumatoid arthritis treated with weekly, low-dose methotrexate", Am J Med, 90, pp.295~298 (1991)
  13. Korelitz BI, "Shingles during the course of treatment with 6-mercaptopurine for inflammatory bowel disease", Am J Gastroenterol, 94, pp.424~426 (1999)
  14. Miller GG, "Herpes simplex and varicella zoster viruses: forgotten but not gone", Am J Transplant, 7, pp.741~747 (2007)
  15. Kim DH, "Factors influencing varicella zoster virus infection after allogeneic peripheral blood stem cell transplantation:low-dose acyclovir prophylaxis and pre-transplant diagnosis of lymphoproliferative disorders", Transpl Infect Dis, 10, pp.90~98 (2008)
  16. Kuo CC, "Risk of herpes zoster in patients treated with long-term hemodialysis: a matched cohort study", Am J Kidney Dis, 59, pp.428~433 (2012)
  17. Wu MY, "Risk of herpes zoster in CKD: a matched-cohort study based on administrative data", Am J Kidney Dis, 60, pp.548~552 (2012)
  18. Kupila L, "Etiology of aseptic meningitis and encephalitis in an adult population", Neurology, 66, pp.75~80 (2006)

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