[CIS-PAGID] Adult with recurrent "Zoster"

[Church, Joseph]

Thank you all for your comments and suggestions regarding the patient
described below.

 

A fellow rotating with us suggested we immunize him with VZV vaccine.
Opinions?

 

Joe Church

 

________________________________

From: Church, Joseph 
Sent: Wednesday, December 29, 2010 4:09 PM
To: 'pagid at list.clinimmsoc.org'
Subject: 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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