Simultaneous VZV and HSV-1 Reactivation after Minor Head Injury

Romina Häfelfinger; Anne-Valérie Burgener; Michael Osthoff; Eliska Potlukova

doi:10.12890/2020_001746

Simultaneous VZV and HSV-1 Reactivation after Minor Head Injury

Eur J Case Rep Intern Med. 2020 Aug 21;7(12):001746. doi: 10.12890/2020_001746. eCollection 2020.

Authors

Romina Häfelfinger¹, Anne-Valérie Burgener¹, Michael Osthoff¹, Eliska Potlukova¹

Affiliation

¹ Division of Internal Medicine, University Hospital Basel, Switzerland and University of Basel, Switzerland.

Abstract

An 81-year-old patient presented to the emergency department with a dark lesion on his forehead and swelling of his left eye, 3 days after a minor forehead injury and skin laceration. He also showed singular papules on his chin, upper chest, upper arms and back, later evolving into vesicles. Polymerase-chain reaction testing of vesicle content was positive for VZV and HSV-1, confirming a diagnosis of disseminated cutaneous herpes virus infection and concomitant HSV-1 reactivation. Antiviral and antibiotic treatment was initiated for 1 week with an immediate response. This case report highlights the association of head trauma and subsequent reactivation of VZV in patients at risk. Simultaneous reactivation of HSV-1 and VZV is rare in immunocompetent patients.

Learning points: Minor trauma can cause VZV and HSV reactivation.Consider herpes virus reactivation in case of unclear rash; the appearance of vesicles can be delayed for a few days.Screen for immunodeficiency disorders in disseminated herpes virus infection; if non-apparent, close monitoring is recommended.

Keywords: Herpes simplex virus; head trauma; varicella zoster virus.