[Objectives]To observe the clinical efficacy of external application of Scorzonera Herpes Ointment combined with Methylprednisolone Sodium Succinate for Injection in the treatment of herpes zoster oticus(HZO).[Methods...[Objectives]To observe the clinical efficacy of external application of Scorzonera Herpes Ointment combined with Methylprednisolone Sodium Succinate for Injection in the treatment of herpes zoster oticus(HZO).[Methods]A total of 100 HZO patients admitted to the 988 th Hospital of the Joint Logistics Support Force and Henan Provincial People's Hospital from June 2021 to June 2023 were selected.They were divided into a treatment group and a control group using a random number table method,with 50 cases in each group.Both groups received Methylprednisolone Sodium Succinate for Injection.Additionally,the treatment group was treated with external application of Scorzonera Herpes Ointment,while the control group received acyclovir ointment.Both groups were treated for 10 d.The comparisons included clinical efficacy,total symptom and sign scores,pain level[Visual Analogue Scale(VAS)],time for erythema reduction,cessation of blister formation,scab formation,and scab shedding,incidence of post-herpetic neuralgia(PHN),air conduction hearing threshold,and air-bone gap.[Results]After 10 d of treatment,the total effective rate was 98.00%(49/50)in the treatment group and 84.00%(42/50)in the control group,with a statistically significant difference between the two groups(P<0.05).After 10 d of treatment,the total symptom and sign scores and VAS scores of both groups decreased compared to those before treatment.The treatment group had significantly lower scores than the control group(P<0.05).The treatment group showed significantly shorter time for erythema reduction,cessation of blister formation,scab formation,and scab shedding compared to the control group(P<0.05).During the 1-month follow-up after treatment,no PHN cases occurred in the treatment group,while the incidence of PHN in the control group was 24.00%(12/50),showing a statistically significant difference(P<0.05).After 10 d of treatment,both groups showed reduced air conduction hearing thresholds,and the treatment group exhibited significantly lower air conduction thresholds and air-bone gaps compared to the control group(P<0.05).No statistically significant difference was observed in the air-bone gap before and after treatment in the control group(P>0.05).[Conclusions]The combination of external application of Scorzonera Herpes Ointment and Methylprednisolone Sodium Succinate for Injection can alleviate pain and other discomforts,reduce PHN incidence,shorten disease duration,and improve hearing in HZO patients.展开更多
Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection du...Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection during childhood[1].HZ tends to occur more frequently in older adults,in whom cellmediated immunity often declines.The incidence of HZ among immunocompetent unvaccinated individuals aged>50y is 9.92/1000 person-years[2].HZ ophthalmicus(HZO)occurs when HZ involves the first division of the trigeminal nerve,i.e.,the ophthalmic nerve[3].展开更多
Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against her...Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against herpes simplex virus 1(HSV-1).By examining different phases of viral infection in human corneal epithelial cells(HCECs),we found that 30μmol/L quercetin inhibits HSV-1 replication primarily by disrupting viral attachment.RNA-sequencing and subsequent analyses revealed that the nuclear factor E2-related factor 2(Nrf2)was upregulated by quercetin in a dose-dependent manner.Knocking down Nrf2 partially compromised quercetin's antiviral effect.Importantly,topical application of 100μmol/L quercetin alleviated HSK severity in mice,reduced viral titers in tears,and inhibited VP16 expression in the cornea and trigeminal ganglia.These findings demonstrate the antiviral effect of quercetin against HSV-1 and provide a foundation for mechanistic studies to elucidate its therapeutic potential in HSK.展开更多
Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not complet...Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not completely understood.Among the molecular mediators of synaptic and cognitive dysfunction occurring after Herpes simplex virus type-1 infection and reactivation in the brain neuroinflammatory cytokines seem to occupy a central role.Here,we specifically reviewed literature reports dealing with the impact of neuroinflammation on synaptic dysfunction observed after recurrent Herpes simplex virus type-1 reactivation in the brain,highlighting the role of interleukins and,in particular,interleukin 1βas a possible target against Herpes simplex virus type-1-induced neuronal dysfunctions.展开更多
BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses...BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.展开更多
BACKGROUND Facial herpes is a common form of the herpes simplex virus-1 infection and usually presents as vesicles near the mouth,nose,and periocular sites.In contrast,we observed a new facial symptom of herpes on the...BACKGROUND Facial herpes is a common form of the herpes simplex virus-1 infection and usually presents as vesicles near the mouth,nose,and periocular sites.In contrast,we observed a new facial symptom of herpes on the entire face without vesicles.CASE SUMMARY A 33-year-old woman with a history of varicella infection and shingles since an early age presented with sarcoidosis of the entire face and neuralgia without oral lesions.The patient was prescribed antiviral treatment with valacyclovir and acyclovir cream.One day after drug administration,facial skin lesions and neurological pain improved.Herpes simplex without oral blisters can easily be misdiagnosed as pimples upon visual examination in an outpatient clinic.CONCLUSION As acute herpes simplex is accompanied by neuralgia,prompt diagnosis and prescription are necessary,considering the pathological history and health conditions.展开更多
BACKGROUND Acyclovir(ACV)-resistant herpes simplex virus(HSV)strains have emerged and gradually increased in number.Prolonged treatment,such as for immunocompromised patients,has been observed on many occasions to lea...BACKGROUND Acyclovir(ACV)-resistant herpes simplex virus(HSV)strains have emerged and gradually increased in number.Prolonged treatment,such as for immunocompromised patients,has been observed on many occasions to lead to the development of resistance.Additionally,some strains of HSV exist that are ACV resistant,and they can cause severe complications that may be impossible to treat with current therapies.We report the first case of ACV-resistant herpes encephalitis(ARHE)recurring in an immunocompromised adult patient without neurosurgical intervention.CASE SUMMARY A 58-year-old man with a fever of 38°C had tremors.Evaluation revealed 14 points on the Glasgow Coma Scale with 39°C fever but unremarkable physical examination.Diagnosis was infection of unknown origin;fever continued,and the Glasgow Coma Scale worsened to 8.Imaging showing a high-intensity area between the left temporal lobe and insular cortex suggested herpes encephalitis.ACV was started.Cerebrospinal fluid(CSF)was positive for HSV DNA,confirming the diagnosis.However,unresolved symptoms suggested ARHE;therefore,we initiated vidarabine treatment.Later testing confirmed ARHE.Foscarnet was started based on a hospital day 25 blood test revealing pancytopenia,possibly from vidarabine.Consciousness improved,and the patient moved to rehabilitation.However,symptoms worsened,suggesting recurrence.Diffusion-weighted magnetic resonance imaging revealed a high high-intensity area around the right temporal lobe;CSF was positive for HSV DNA,confirming recurrent herpes encephalitis.ACV and foscarnet were initiated.Fever decreased,consciousness improved,and HSV DNA on hospital days 78 and 93 was CSF negative.Treatment was terminated on hospital day 86.CONCLUSION ARHE recurred in the patient following remission;therefore,it is necessary to discuss the length of the treatment period.展开更多
BACKGROUND Erythrodermic psoriasis(EP)is a rare and life-threatening form of psoriasis associated with significant morbidity and mortality.Systemic immunosuppre-ssive therapies are often required but may predispose to...BACKGROUND Erythrodermic psoriasis(EP)is a rare and life-threatening form of psoriasis associated with significant morbidity and mortality.Systemic immunosuppre-ssive therapies are often required but may predispose to opportunistic infections.Disseminated herpes simplex virus type-1(HSV-1)is an unusual complication in otherwise immunocompetent patients and has not been reported in association with ixekizumab therapy for EP.CASE SUMMARY We describe a 49-year-old man with longstanding severe plaque psoriasis,liver cirrhosis,and bipolar disorder who developed EP involving>90%of body surface area[Psoriasis Area and Severity Index(PASI)45].Following initial stabil-ization,he was admitted to the intensive care unit(ICU)with hemodynamic instability,leukocytosis with eosinophilia,and diffuse desquamation.Ixekizumab was initiated with high-dose topical clobetasol.During his ICU stay,he developed recurrent bacteremias and neurologic decline(Glasgow Coma Scale 7/15),fo-llowed by the appearance of widespread vesicles and hemorrhagic crusts.HSV-1 infection was confirmed by polymerase chain reaction(PCR).Immunosuppressive therapy was withheld,and intravenous acyclovir was started,leading to progre-ssive improvement.After ten days,ixekizumab was reintroduced with careful monitoring,resulting in marked clinical improvement(PASI 9.7 at six weeks).The patient remained stable on long-term follow-up with oral acyclovir prophylaxis.CONCLUSION This case highlights the diagnostic and therapeutic challenges of managing EP in the setting of biologic therapy.Disseminated cutaneous HSV-1 should be considered in immunosuppressed patients presenting with new vesicular eruptions,and prompt PCR testing with early antiviral therapy is essential.A multidisciplinary approach is critical to balance immunosuppression for disease control with infection risk.展开更多
Dear Editor,I am Dr.Asako Kodama,affiliated with the Department of Ophthalmology at Eiju General Hospital in Tokyo,Japan.Varicella-zoster virus(VZV)induces two distinct states:the primary infection(varicella)and secon...Dear Editor,I am Dr.Asako Kodama,affiliated with the Department of Ophthalmology at Eiju General Hospital in Tokyo,Japan.Varicella-zoster virus(VZV)induces two distinct states:the primary infection(varicella)and secondary endogenous reactivation of latent VZV in herpes zoster form.While herpes zoster lesions typically manifest on the trunk and abdomen,the most frequently involved cranial nerve is the trigeminal nerve.展开更多
[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mech...[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mechanism.[Methods]96 patients with PHN were divided into the control group(group A)and observation group(group B)(n=48).In group A,the patients were given gabapentin orally and treated by cotton moxibustion.In group B,the patients were treated by the external application of self-prepared Chinese prescription decoction on the basis of the above basic treatment.The total effective rate,apparent time and recurrence rate of the two groups were compared.[Results]The cure rate(72.91%)and total effective rate(95.83%)of patients in group B were higher than those in group A(54.16%,83.33%).The average apparent time[(5.79±1.40)d]and recurrence rate(5.97%)of patients in group B were significantly lower than those in group A[(7.03±4.37)d,10.45%],and the difference between the two groups was statistically significant(P<0.05).[Conclusions]The external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion therapy had a significant curative effect and low recurrence rate.展开更多
Objective To compare the difference of clinical efficacy of thin cotton moxibustion combined with plum-blossom needle and western medication in treatment of herpes zoster.Method Eighty patients with herpes zoster were...Objective To compare the difference of clinical efficacy of thin cotton moxibustion combined with plum-blossom needle and western medication in treatment of herpes zoster.Method Eighty patients with herpes zoster were divided into thin cotton moxibustion group（group A,n=40） and western medication group（group B,n=40） according to the sequence of admission.Patients in group A received thin cotton moxibustion that the colton was used as thin as a cicada＇s wings,combined with plum-blossom needle,and patients in group B received intravenous infusion with 0.25 g of acyclovir once a day,and acyclovir ointment application on affected part for 3-5 times per day.Five days were considered as a course of treatment.Analgesic effect and the incidence of postherpetic neuralgia were observed after two consecutive courses.Result The total effective rate was 97.5%（39/40） in group A,and80.0%（32/40） in group B（P〈0.05）;it was shown from the comparison of course between two groups that the cure rate after one in group A was markedly higher than that in group B（P〈0.01,P〈0.05）;the differences in effectual time and analgesic time between group A and group B were statistically significant（P〈0.05）;after treatment,the incidence of postherpetic neuralgia in group A was markedly lower than that in group B（P〈0.05）.Conclusion Thin cotton moxibustion combined with plum-blossom needle in treatment of herpes zoster can obviously shorten the time of therapy,effectively control pain,and reduce the incidence of postherpetic neuralgia.展开更多
BACKGROUND Herpes simplex virus(HSV)is a highly infectious pathogen that is easily transmitted via the bodily fluids of an infected individual.This virus usually affects individuals older than six months of age,and ra...BACKGROUND Herpes simplex virus(HSV)is a highly infectious pathogen that is easily transmitted via the bodily fluids of an infected individual.This virus usually affects individuals older than six months of age,and rarely causes lesions or symptoms in younger patients.CASE SUMMARY We present the case of a five-month-old healthy girl who presented with painful herpetic gingivostomatitis and perioral vesicles.We discuss the pathophysiology of primary HSV infection and the effect of maternal antibodies on the infant’s immune system.In addition,we explain the diagnosis,management,and prognosis of HSV infection in young infants.CONCLUSION This case highlights the importance of early diagnosis and management of HSV infections to decrease the risk of developing severe complications and death.展开更多
Herpes zoster(HZ)is an acute infectious disease caused by varicella-zoster virus.The neurological sequelae of HZ include postherpetic neuralgia(PHN)and postherpetic itch(PHI).Severe pain and recurrent itching seriousl...Herpes zoster(HZ)is an acute infectious disease caused by varicella-zoster virus.The neurological sequelae of HZ include postherpetic neuralgia(PHN)and postherpetic itch(PHI).Severe pain and recurrent itching seriously affect the quality of life of patients.The pathogenesis of PHN is related to the mediation of immune-inflammatory response,activation of neuroglial cells,structural and functional alterations of the brain,aberrant expression of ion channels,and gene mediation.Overall,the immune-inflammatory response is a key factor mediating the pathogenesis of PHN.By reviewing the literature,the authors found that there are few studies on PHN both at home and abroad,so its pathogenesis is still unclear.No new progress has been made in recent years either,resulting in the understanding of PHI remaining in a state of confusion.The pathogenesis of PHI may be related to the loss of epidermal nerves,excitation of itch-specific neurons,absence of itch-inhibitory neurons,the action of itch-causing factors,and the vicious circle of itch and mood disorders.In general,most of them are conjectures,not supported by relevant experimental data.The treatments for PHN are varied and effective,while the pathogenesis of PHI is still unclear,so the treatment is often passive.This paper reviews the pathogenesis of PHN and PHI,expecting to provide new ideas for clinical treatment.展开更多
Objective To observe the analgesic effect on herpes zoster treated by the comprehensive therapy of blocking, surrounding needling, pricking and cupping combined with bloodletting at Longyan （龙眼, Extra） acupoint. M...Objective To observe the analgesic effect on herpes zoster treated by the comprehensive therapy of blocking, surrounding needling, pricking and cupping combined with bloodletting at Longyan （龙眼, Extra） acupoint. Methods According to the random mumber table, 104 cases of herpes zoster were randomized into an observation group and a control group, 52 cases in each one. In the observation group, the blocking method was used at the starting site and the ending site of herpetic zone, the surrounding needling method was applied toward the center of the painful zone, with horizontal needling technique; and the local pricking and cupping methods as well as the bloodletting at Longyan （Extra） acupoint were adopted. In the control group, Jiáj （夹脊 EX-B 2） at the corresponding affected nerve segments and the local Ashi points were selected and stimulated with electroacupuncture. The visual analogue scale （VAS） was adopted to determine the analgesic effect 20 min, 1, 6, 12, 24 and 48 h after treatment separately in each group. Results The onset time of analgesic effect in the observation group was shorter than that in the control group and the efficacy time of duration was longer than that in the control group （all P0.05）. The analgesic effect and the result of comprehensive efficacy assessment were superior to those of the control group （both P0.05）. Conclusion The comprehensive therapy of blocking, surrounding needling, pricking and cupping method combined with bloodletting at Longyan （Extra） achieves the significant analgesic effect on herpes zoster.展开更多
ABSTRACT Objective To compare the efficacy difference between point injection at Jiiaji （夹脊 EX-B 2） and oral medication in the treatment of intractable post-herpetic neuralgia （PHN） in the trunk. Methods One hun...ABSTRACT Objective To compare the efficacy difference between point injection at Jiiaji （夹脊 EX-B 2） and oral medication in the treatment of intractable post-herpetic neuralgia （PHN） in the trunk. Methods One hundred and thirty cases were randomly divided into an point injection group and an medication group, 65 cases in each one. In point injection group, according to the invasion site of herpes zoster, Jiiaji （夹脊 EX-B 2） of corresponding segments and the meridian points on skin lesion areas, such as Fengchi （风池GB 20）, Tianzhu （天柱 BL 10）, Feishu （肺俞 BL 13） and Geguan （膈关 BL 46） were selected and injected with the mixed solution of compound Betamethasone （administered only in the first injection）, Vitamin B12 and Lidoeaine Carbonate, 2 mL on each point, once per day. In medication group, Diclofenac Sodium sustained release tablets, 75 mg were administered, twice per day. The clinical efficacy was compared 10 days later between two groups. Results The total effective rate in point injection group was 100.0% （65/65）, which was better than 66.1% （43/65） in medication group （P〈0.01）. Conclusion Point injection mainly at Jiiaji （夹脊 EX-B 2） is effective significantly on intractable PHN in the trunk, which is superior to Diclofenac Sodium sustained release tablets.展开更多
Postherpetic neuralgia(PHN) is a severe sequela of herpes zoster(HZ).Until now,only age and pain severity were considered predisposing factors for the development of PHN.We evaluated 49 patients with acute phase HZ,10...Postherpetic neuralgia(PHN) is a severe sequela of herpes zoster(HZ).Until now,only age and pain severity were considered predisposing factors for the development of PHN.We evaluated 49 patients with acute phase HZ,10 of whom developed PHN(Group A) and 39 of whom did not develop PHN(Group B).Twenty-five healthy volunteers similar in age and gender distribution to the study group were recruited as controls(Group C).Numbers of serum CD3+(pan-T lymphocytes),CD4+(helper/inducer),and CD8+(suppressor/cytotoxic) lymphocytes were decreased significantly in Groups A and B relative to the control group,but there were no statistical differences between Groups A and B.Interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-α,IL-8,and IL-10 were significantly elevated in Groups A and B relative to Group C.IL-6 was significantly higher in Group A than in Group B,and was significantly positively correlated with pain severity scored on a visual analog scale.Therefore,we suggest that the inflammatory response,especially that of IL-6,in the acute phase of HZ may be associated with hyperalgesia and the development of PHN.展开更多
Objective To evaluate the clinical effect of acupuncture combined with direct moxibustion with fine-strip moxa for herpes zoster. Methods Sixty-two patients with herpes zoster were randomly divided into two groups acc...Objective To evaluate the clinical effect of acupuncture combined with direct moxibustion with fine-strip moxa for herpes zoster. Methods Sixty-two patients with herpes zoster were randomly divided into two groups according to attendance number, 32 in acupuncture group and 30 in western medicine group. The patients in the acupuncture group were treated by acupuncture at the nidus-related nerve segments Jiaji （夹脊 EX-B2） in combination with direct moxibustion with fine-strip moxa, while the patients in the western medicine group were treated by oral valaciclovir hydrochloride, vitamin B1, vitamin B12. The times of response, incrustation and decrustation were observed respectively, and pain relief degree of the two groups were compared. Results The response time, incrustation time and decrustation time of the acupuncture group were all less than those of the western medicine group [（1.74±0.43） days vs （3.86±0.58） days, （2.03±0.52） days vs （5.46±0.65） days, （5.14±0.33） days vs （8.34±0.59） days, all P〈O.05]. The pain relief degree （VAS score）, and pain duration in the acupuncture group were all higher obviously than those of the western medicine group [（10.41±12.1） vs （15.63±11.39）, （4.78±0.45） days vs （8.12±0.63） days, all P〈O.05]. The total effective rate of the acupuncture group was 96.9% （31/32）and that of the western medicine group was 90% （27/30）, thus the therapeutic effect of acupuncture group was better than that of western medicine group （P〈0.05）. Conclusion The therapeutic effect of acupuncture combined with direct moxibustion with fine-strip moxa is remarkable. It can effectively control the development of herpes zoster, alleviate pain and shorten therapy periods. It is worthy to be promoted and applied.展开更多
BACKGROUND Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention.The pathogenesis of neuralgia caused by varicellazoster virus infection of the trigeminal nerve is m...BACKGROUND Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention.The pathogenesis of neuralgia caused by varicellazoster virus infection of the trigeminal nerve is more complex,and it is still difficult to relieve the pain in some patients simply by drug treatment or surgical intervention.CASE SUMMARY A 66-year-old woman was hospitalized with herpetic neuralgia after herpes zoster ophthalmicus(varicella-zoster virus infects the ophthalmic branch of the trigeminal nerve).On admission,the patient showed spontaneous,electric shocklike and acupuncture-like severe pain in the left frontal parietal region,and pain could be induced by touching the herpes area.The numerical rating scale(NRS)was 9.There was no significant pain relief after pulsed radiofrequency and thermocoagulation of the ophthalmic branch of the trigeminal nerve.Combined with patient-controlled intravenous analgesia(PCIA)with esketamine,neuralgia was significantly improved.The patient had no spontaneous pain or allodynia at discharge,and the NRS score decreased to 2 points.The results of follow-up 2 mo after discharge showed that the NRS score was≤3,and the Pittsburgh Sleep Quality Index score was 5 points.There were no adverse reactions.CONCLUSION Trigeminal extracranial thermocoagulation combined with esketamine PCIA may be a feasible method for the treatment of refractory herpetic neuralgia after herpes zoster ophthalmicus.展开更多
基金Supported by the Joint Construction Project of Medical Science and Technology Research Plan in Henan Province(LHGJ20190879).
文摘[Objectives]To observe the clinical efficacy of external application of Scorzonera Herpes Ointment combined with Methylprednisolone Sodium Succinate for Injection in the treatment of herpes zoster oticus(HZO).[Methods]A total of 100 HZO patients admitted to the 988 th Hospital of the Joint Logistics Support Force and Henan Provincial People's Hospital from June 2021 to June 2023 were selected.They were divided into a treatment group and a control group using a random number table method,with 50 cases in each group.Both groups received Methylprednisolone Sodium Succinate for Injection.Additionally,the treatment group was treated with external application of Scorzonera Herpes Ointment,while the control group received acyclovir ointment.Both groups were treated for 10 d.The comparisons included clinical efficacy,total symptom and sign scores,pain level[Visual Analogue Scale(VAS)],time for erythema reduction,cessation of blister formation,scab formation,and scab shedding,incidence of post-herpetic neuralgia(PHN),air conduction hearing threshold,and air-bone gap.[Results]After 10 d of treatment,the total effective rate was 98.00%(49/50)in the treatment group and 84.00%(42/50)in the control group,with a statistically significant difference between the two groups(P<0.05).After 10 d of treatment,the total symptom and sign scores and VAS scores of both groups decreased compared to those before treatment.The treatment group had significantly lower scores than the control group(P<0.05).The treatment group showed significantly shorter time for erythema reduction,cessation of blister formation,scab formation,and scab shedding compared to the control group(P<0.05).During the 1-month follow-up after treatment,no PHN cases occurred in the treatment group,while the incidence of PHN in the control group was 24.00%(12/50),showing a statistically significant difference(P<0.05).After 10 d of treatment,both groups showed reduced air conduction hearing thresholds,and the treatment group exhibited significantly lower air conduction thresholds and air-bone gaps compared to the control group(P<0.05).No statistically significant difference was observed in the air-bone gap before and after treatment in the control group(P>0.05).[Conclusions]The combination of external application of Scorzonera Herpes Ointment and Methylprednisolone Sodium Succinate for Injection can alleviate pain and other discomforts,reduce PHN incidence,shorten disease duration,and improve hearing in HZO patients.
文摘Dear Editor,Herpes zoster(HZ),which is characterized by a unilateral painful dermatomal rash,is caused by reactivation of the latent varicella-zoster virus(VZV)in the dorsal root ganglia following primary infection during childhood[1].HZ tends to occur more frequently in older adults,in whom cellmediated immunity often declines.The incidence of HZ among immunocompetent unvaccinated individuals aged>50y is 9.92/1000 person-years[2].HZ ophthalmicus(HZO)occurs when HZ involves the first division of the trigeminal nerve,i.e.,the ophthalmic nerve[3].
基金supported by the National Natural Science Foundation of China(No.81970848).
文摘Quercetin is a natural compound with potent antiviral effects;however,its role in the treatment of herpes simplex keratitis(HSK)remains underexplored.Here,we investigated the antiviral effects of quercetin against herpes simplex virus 1(HSV-1).By examining different phases of viral infection in human corneal epithelial cells(HCECs),we found that 30μmol/L quercetin inhibits HSV-1 replication primarily by disrupting viral attachment.RNA-sequencing and subsequent analyses revealed that the nuclear factor E2-related factor 2(Nrf2)was upregulated by quercetin in a dose-dependent manner.Knocking down Nrf2 partially compromised quercetin's antiviral effect.Importantly,topical application of 100μmol/L quercetin alleviated HSK severity in mice,reduced viral titers in tears,and inhibited VP16 expression in the cornea and trigeminal ganglia.These findings demonstrate the antiviral effect of quercetin against HSV-1 and provide a foundation for mechanistic studies to elucidate its therapeutic potential in HSK.
基金supported by UniversitàCattolica(D1 intramural funds to RP)Italian Ministry of University and Research(PRIN 2022ZYLB7B,P2022YW7BP funds to CG).
文摘Several experimental evidence suggests a link between brain Herpes simplex virus type-1 infection and the occurrence of Alzheimer’s disease.However,the molecular mechanisms underlying this association are not completely understood.Among the molecular mediators of synaptic and cognitive dysfunction occurring after Herpes simplex virus type-1 infection and reactivation in the brain neuroinflammatory cytokines seem to occupy a central role.Here,we specifically reviewed literature reports dealing with the impact of neuroinflammation on synaptic dysfunction observed after recurrent Herpes simplex virus type-1 reactivation in the brain,highlighting the role of interleukins and,in particular,interleukin 1βas a possible target against Herpes simplex virus type-1-induced neuronal dysfunctions.
文摘BACKGROUND Aseptic meningitis is defined as meningeal inflammation caused by various etio-logies with negative cerebrospinal fluid(CSF)bacterial culture.The most common etiologies are viruses[enteroviruses,arboviruses,and herpes simplex virus type 2(HSV-2)].Aseptic meningitis can have various presentations,including sensori-neural deafness.While sensorineural deafness from mumps meningoencephalitis has been reported,cases of HSV-2-induced hearing loss are rare.Herein,we re-port a case of HSV-2-induced meningitis that presented with sudden deafness.CASE SUMMARY A 68-year-old man experienced a profound sudden onset of left-sided hearing loss for one day.Pure-tone audiograms demonstrated sudden left-sided sensorineural hearing loss(thresholds 80-90 dB).After treatment with high-dose steroids for 1 week,he experienced an acute consciousness change with left hemiparesis.The laboratory data showed no significant abnormalities.Brain computed tomography without contrast and magnetic resonance imaging revealed no intracranial hemo-rrhage or obvious brain lesion.The CSF analysis and the Multiplex PCR panels showed HSV-2 positivity.Hence,under the diagnosis of herpes meningoenceph-alitis,acyclovir was prescribed and his symptoms gradually resolved.CONCLUSION This case report further demonstrates that a viral infection could be a cause of sudden sensorineural hearing loss.
文摘BACKGROUND Facial herpes is a common form of the herpes simplex virus-1 infection and usually presents as vesicles near the mouth,nose,and periocular sites.In contrast,we observed a new facial symptom of herpes on the entire face without vesicles.CASE SUMMARY A 33-year-old woman with a history of varicella infection and shingles since an early age presented with sarcoidosis of the entire face and neuralgia without oral lesions.The patient was prescribed antiviral treatment with valacyclovir and acyclovir cream.One day after drug administration,facial skin lesions and neurological pain improved.Herpes simplex without oral blisters can easily be misdiagnosed as pimples upon visual examination in an outpatient clinic.CONCLUSION As acute herpes simplex is accompanied by neuralgia,prompt diagnosis and prescription are necessary,considering the pathological history and health conditions.
基金Supported by the Japan Society for the Promotion of Science KAKENHI Grant,No.JP24K15491.
文摘BACKGROUND Acyclovir(ACV)-resistant herpes simplex virus(HSV)strains have emerged and gradually increased in number.Prolonged treatment,such as for immunocompromised patients,has been observed on many occasions to lead to the development of resistance.Additionally,some strains of HSV exist that are ACV resistant,and they can cause severe complications that may be impossible to treat with current therapies.We report the first case of ACV-resistant herpes encephalitis(ARHE)recurring in an immunocompromised adult patient without neurosurgical intervention.CASE SUMMARY A 58-year-old man with a fever of 38°C had tremors.Evaluation revealed 14 points on the Glasgow Coma Scale with 39°C fever but unremarkable physical examination.Diagnosis was infection of unknown origin;fever continued,and the Glasgow Coma Scale worsened to 8.Imaging showing a high-intensity area between the left temporal lobe and insular cortex suggested herpes encephalitis.ACV was started.Cerebrospinal fluid(CSF)was positive for HSV DNA,confirming the diagnosis.However,unresolved symptoms suggested ARHE;therefore,we initiated vidarabine treatment.Later testing confirmed ARHE.Foscarnet was started based on a hospital day 25 blood test revealing pancytopenia,possibly from vidarabine.Consciousness improved,and the patient moved to rehabilitation.However,symptoms worsened,suggesting recurrence.Diffusion-weighted magnetic resonance imaging revealed a high high-intensity area around the right temporal lobe;CSF was positive for HSV DNA,confirming recurrent herpes encephalitis.ACV and foscarnet were initiated.Fever decreased,consciousness improved,and HSV DNA on hospital days 78 and 93 was CSF negative.Treatment was terminated on hospital day 86.CONCLUSION ARHE recurred in the patient following remission;therefore,it is necessary to discuss the length of the treatment period.
文摘BACKGROUND Erythrodermic psoriasis(EP)is a rare and life-threatening form of psoriasis associated with significant morbidity and mortality.Systemic immunosuppre-ssive therapies are often required but may predispose to opportunistic infections.Disseminated herpes simplex virus type-1(HSV-1)is an unusual complication in otherwise immunocompetent patients and has not been reported in association with ixekizumab therapy for EP.CASE SUMMARY We describe a 49-year-old man with longstanding severe plaque psoriasis,liver cirrhosis,and bipolar disorder who developed EP involving>90%of body surface area[Psoriasis Area and Severity Index(PASI)45].Following initial stabil-ization,he was admitted to the intensive care unit(ICU)with hemodynamic instability,leukocytosis with eosinophilia,and diffuse desquamation.Ixekizumab was initiated with high-dose topical clobetasol.During his ICU stay,he developed recurrent bacteremias and neurologic decline(Glasgow Coma Scale 7/15),fo-llowed by the appearance of widespread vesicles and hemorrhagic crusts.HSV-1 infection was confirmed by polymerase chain reaction(PCR).Immunosuppressive therapy was withheld,and intravenous acyclovir was started,leading to progre-ssive improvement.After ten days,ixekizumab was reintroduced with careful monitoring,resulting in marked clinical improvement(PASI 9.7 at six weeks).The patient remained stable on long-term follow-up with oral acyclovir prophylaxis.CONCLUSION This case highlights the diagnostic and therapeutic challenges of managing EP in the setting of biologic therapy.Disseminated cutaneous HSV-1 should be considered in immunosuppressed patients presenting with new vesicular eruptions,and prompt PCR testing with early antiviral therapy is essential.A multidisciplinary approach is critical to balance immunosuppression for disease control with infection risk.
文摘Dear Editor,I am Dr.Asako Kodama,affiliated with the Department of Ophthalmology at Eiju General Hospital in Tokyo,Japan.Varicella-zoster virus(VZV)induces two distinct states:the primary infection(varicella)and secondary endogenous reactivation of latent VZV in herpes zoster form.While herpes zoster lesions typically manifest on the trunk and abdomen,the most frequently involved cranial nerve is the trigeminal nerve.
文摘[Objectives]To discuss the curative effect of the external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion on postherpetic neuralgia(PHN)and analyze its mechanism.[Methods]96 patients with PHN were divided into the control group(group A)and observation group(group B)(n=48).In group A,the patients were given gabapentin orally and treated by cotton moxibustion.In group B,the patients were treated by the external application of self-prepared Chinese prescription decoction on the basis of the above basic treatment.The total effective rate,apparent time and recurrence rate of the two groups were compared.[Results]The cure rate(72.91%)and total effective rate(95.83%)of patients in group B were higher than those in group A(54.16%,83.33%).The average apparent time[(5.79±1.40)d]and recurrence rate(5.97%)of patients in group B were significantly lower than those in group A[(7.03±4.37)d,10.45%],and the difference between the two groups was statistically significant(P<0.05).[Conclusions]The external application of self-prepared Chinese prescription decoction combined with gabapentin and cotton moxibustion therapy had a significant curative effect and low recurrence rate.
文摘Objective To compare the difference of clinical efficacy of thin cotton moxibustion combined with plum-blossom needle and western medication in treatment of herpes zoster.Method Eighty patients with herpes zoster were divided into thin cotton moxibustion group（group A,n=40） and western medication group（group B,n=40） according to the sequence of admission.Patients in group A received thin cotton moxibustion that the colton was used as thin as a cicada＇s wings,combined with plum-blossom needle,and patients in group B received intravenous infusion with 0.25 g of acyclovir once a day,and acyclovir ointment application on affected part for 3-5 times per day.Five days were considered as a course of treatment.Analgesic effect and the incidence of postherpetic neuralgia were observed after two consecutive courses.Result The total effective rate was 97.5%（39/40） in group A,and80.0%（32/40） in group B（P〈0.05）;it was shown from the comparison of course between two groups that the cure rate after one in group A was markedly higher than that in group B（P〈0.01,P〈0.05）;the differences in effectual time and analgesic time between group A and group B were statistically significant（P〈0.05）;after treatment,the incidence of postherpetic neuralgia in group A was markedly lower than that in group B（P〈0.05）.Conclusion Thin cotton moxibustion combined with plum-blossom needle in treatment of herpes zoster can obviously shorten the time of therapy,effectively control pain,and reduce the incidence of postherpetic neuralgia.
基金Deanship of Scientific Research at Princess Nourah bint Abdulrahman University through the Fast-track Research Funding Program.
文摘BACKGROUND Herpes simplex virus(HSV)is a highly infectious pathogen that is easily transmitted via the bodily fluids of an infected individual.This virus usually affects individuals older than six months of age,and rarely causes lesions or symptoms in younger patients.CASE SUMMARY We present the case of a five-month-old healthy girl who presented with painful herpetic gingivostomatitis and perioral vesicles.We discuss the pathophysiology of primary HSV infection and the effect of maternal antibodies on the infant’s immune system.In addition,we explain the diagnosis,management,and prognosis of HSV infection in young infants.CONCLUSION This case highlights the importance of early diagnosis and management of HSV infections to decrease the risk of developing severe complications and death.
文摘Herpes zoster(HZ)is an acute infectious disease caused by varicella-zoster virus.The neurological sequelae of HZ include postherpetic neuralgia(PHN)and postherpetic itch(PHI).Severe pain and recurrent itching seriously affect the quality of life of patients.The pathogenesis of PHN is related to the mediation of immune-inflammatory response,activation of neuroglial cells,structural and functional alterations of the brain,aberrant expression of ion channels,and gene mediation.Overall,the immune-inflammatory response is a key factor mediating the pathogenesis of PHN.By reviewing the literature,the authors found that there are few studies on PHN both at home and abroad,so its pathogenesis is still unclear.No new progress has been made in recent years either,resulting in the understanding of PHI remaining in a state of confusion.The pathogenesis of PHI may be related to the loss of epidermal nerves,excitation of itch-specific neurons,absence of itch-inhibitory neurons,the action of itch-causing factors,and the vicious circle of itch and mood disorders.In general,most of them are conjectures,not supported by relevant experimental data.The treatments for PHN are varied and effective,while the pathogenesis of PHI is still unclear,so the treatment is often passive.This paper reviews the pathogenesis of PHN and PHI,expecting to provide new ideas for clinical treatment.
文摘Objective To observe the analgesic effect on herpes zoster treated by the comprehensive therapy of blocking, surrounding needling, pricking and cupping combined with bloodletting at Longyan （龙眼, Extra） acupoint. Methods According to the random mumber table, 104 cases of herpes zoster were randomized into an observation group and a control group, 52 cases in each one. In the observation group, the blocking method was used at the starting site and the ending site of herpetic zone, the surrounding needling method was applied toward the center of the painful zone, with horizontal needling technique; and the local pricking and cupping methods as well as the bloodletting at Longyan （Extra） acupoint were adopted. In the control group, Jiáj （夹脊 EX-B 2） at the corresponding affected nerve segments and the local Ashi points were selected and stimulated with electroacupuncture. The visual analogue scale （VAS） was adopted to determine the analgesic effect 20 min, 1, 6, 12, 24 and 48 h after treatment separately in each group. Results The onset time of analgesic effect in the observation group was shorter than that in the control group and the efficacy time of duration was longer than that in the control group （all P0.05）. The analgesic effect and the result of comprehensive efficacy assessment were superior to those of the control group （both P0.05）. Conclusion The comprehensive therapy of blocking, surrounding needling, pricking and cupping method combined with bloodletting at Longyan （Extra） achieves the significant analgesic effect on herpes zoster.
文摘ABSTRACT Objective To compare the efficacy difference between point injection at Jiiaji （夹脊 EX-B 2） and oral medication in the treatment of intractable post-herpetic neuralgia （PHN） in the trunk. Methods One hundred and thirty cases were randomly divided into an point injection group and an medication group, 65 cases in each one. In point injection group, according to the invasion site of herpes zoster, Jiiaji （夹脊 EX-B 2） of corresponding segments and the meridian points on skin lesion areas, such as Fengchi （风池GB 20）, Tianzhu （天柱 BL 10）, Feishu （肺俞 BL 13） and Geguan （膈关 BL 46） were selected and injected with the mixed solution of compound Betamethasone （administered only in the first injection）, Vitamin B12 and Lidoeaine Carbonate, 2 mL on each point, once per day. In medication group, Diclofenac Sodium sustained release tablets, 75 mg were administered, twice per day. The clinical efficacy was compared 10 days later between two groups. Results The total effective rate in point injection group was 100.0% （65/65）, which was better than 66.1% （43/65） in medication group （P〈0.01）. Conclusion Point injection mainly at Jiiaji （夹脊 EX-B 2） is effective significantly on intractable PHN in the trunk, which is superior to Diclofenac Sodium sustained release tablets.
基金Project (No.2008ZYC07) supported by the Zhejiang Medical Bureau of China
文摘Postherpetic neuralgia(PHN) is a severe sequela of herpes zoster(HZ).Until now,only age and pain severity were considered predisposing factors for the development of PHN.We evaluated 49 patients with acute phase HZ,10 of whom developed PHN(Group A) and 39 of whom did not develop PHN(Group B).Twenty-five healthy volunteers similar in age and gender distribution to the study group were recruited as controls(Group C).Numbers of serum CD3+(pan-T lymphocytes),CD4+(helper/inducer),and CD8+(suppressor/cytotoxic) lymphocytes were decreased significantly in Groups A and B relative to the control group,but there were no statistical differences between Groups A and B.Interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-α,IL-8,and IL-10 were significantly elevated in Groups A and B relative to Group C.IL-6 was significantly higher in Group A than in Group B,and was significantly positively correlated with pain severity scored on a visual analog scale.Therefore,we suggest that the inflammatory response,especially that of IL-6,in the acute phase of HZ may be associated with hyperalgesia and the development of PHN.
文摘Objective To evaluate the clinical effect of acupuncture combined with direct moxibustion with fine-strip moxa for herpes zoster. Methods Sixty-two patients with herpes zoster were randomly divided into two groups according to attendance number, 32 in acupuncture group and 30 in western medicine group. The patients in the acupuncture group were treated by acupuncture at the nidus-related nerve segments Jiaji （夹脊 EX-B2） in combination with direct moxibustion with fine-strip moxa, while the patients in the western medicine group were treated by oral valaciclovir hydrochloride, vitamin B1, vitamin B12. The times of response, incrustation and decrustation were observed respectively, and pain relief degree of the two groups were compared. Results The response time, incrustation time and decrustation time of the acupuncture group were all less than those of the western medicine group [（1.74±0.43） days vs （3.86±0.58） days, （2.03±0.52） days vs （5.46±0.65） days, （5.14±0.33） days vs （8.34±0.59） days, all P〈O.05]. The pain relief degree （VAS score）, and pain duration in the acupuncture group were all higher obviously than those of the western medicine group [（10.41±12.1） vs （15.63±11.39）, （4.78±0.45） days vs （8.12±0.63） days, all P〈O.05]. The total effective rate of the acupuncture group was 96.9% （31/32）and that of the western medicine group was 90% （27/30）, thus the therapeutic effect of acupuncture group was better than that of western medicine group （P〈0.05）. Conclusion The therapeutic effect of acupuncture combined with direct moxibustion with fine-strip moxa is remarkable. It can effectively control the development of herpes zoster, alleviate pain and shorten therapy periods. It is worthy to be promoted and applied.
文摘BACKGROUND Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention.The pathogenesis of neuralgia caused by varicellazoster virus infection of the trigeminal nerve is more complex,and it is still difficult to relieve the pain in some patients simply by drug treatment or surgical intervention.CASE SUMMARY A 66-year-old woman was hospitalized with herpetic neuralgia after herpes zoster ophthalmicus(varicella-zoster virus infects the ophthalmic branch of the trigeminal nerve).On admission,the patient showed spontaneous,electric shocklike and acupuncture-like severe pain in the left frontal parietal region,and pain could be induced by touching the herpes area.The numerical rating scale(NRS)was 9.There was no significant pain relief after pulsed radiofrequency and thermocoagulation of the ophthalmic branch of the trigeminal nerve.Combined with patient-controlled intravenous analgesia(PCIA)with esketamine,neuralgia was significantly improved.The patient had no spontaneous pain or allodynia at discharge,and the NRS score decreased to 2 points.The results of follow-up 2 mo after discharge showed that the NRS score was≤3,and the Pittsburgh Sleep Quality Index score was 5 points.There were no adverse reactions.CONCLUSION Trigeminal extracranial thermocoagulation combined with esketamine PCIA may be a feasible method for the treatment of refractory herpetic neuralgia after herpes zoster ophthalmicus.
