[CIS-PAGID] Adult with recurrent "Zoster"

[Berger, Melvin]

1. Good old-fashioned DTH skin tests.  2. T-cell response by Elispot to autologous cells infected with VZV - see what cytokines he makes compared to controls. 3. TLR responses. 4. Reminders to take his prophylaxis. 
 
Melvin Berger, M.D., Ph.D.
Adjunct Professor of Pediatrics and Pathology
Case Western Reserve University
Cleveland, OH 44106

________________________________

From: pagid-bounces at list.clinimmsoc.org on behalf of Church, Joseph
Sent: Wed 12/29/2010 7:09 PM
To: pagid at list.clinimmsoc.org
Subject: [CIS-PAGID] Adult with recurrent "Zoster"



Colleagues:

 

A 57yo man was referred for recurrent Herpes zoster.   Lesions have recurred ~ 2 times a year for 20 years.  They affect the same facial location (right ear).  Outbreaks are associated with increased stress and missing Valtrex prophylaxis.  He has absolutely no other infectious history and is otherwise healthy.  

 

NORMAL laboratory findings include the following:

*	CBC, CMP, sed rate, CRP 
*	IgG, IgA, IgM 
*	Antibody responses to tetanus, hepatitis A and Pneumovaxtm 
*	T, B and NK numbers 
*	PHA and PWM LPAs 
*	Tetanus, Candida and VZV LPAs 
*	NK cytotoxicity (Cincinnati Children's) 
*	CTL cytotoxicity (Cincinnati Children's) 

 

Other than the possibility that these episodes are not VZV-related, does anyone have any other ideas?

 

Joe Church

Children's Hospital Los Angeles

 

 


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