11/12. herpes zoster ophthalmicus and the immunocompromised host: a case report and review.BACKGROUND: Herpes zoster is the secondary form of varicella zoster virus disease, caused by the reactivation of the dormant virus in the sensory ganglia. It manifests as a unilateral cutaneous dermatitis with a prodromal fever and malaise. herpes zoster ophthalmicus occurs when the ophthalmic division of the trigeminal nerve becomes afflicted. case reports: This case represents a middle-aged female with breast carcinoma. Cancer radiotherapy and chemotherapy created an immunosuppressed state, which allowed the development of herpes zoster ophthalmicus. Most patients who manifest zoster are immunocompetent. However, with the increased incidence of immunodeficient states (e.g., chemotherapy, organ transplantation and acquired immunodeficiency syndrome), clinicians are faced with a greater number of cases of zoster. In the immunodeficient population, especially, dissemination of the zoster and potentially damaging complications can occur. CONCLUSIONS: In the light of these facts, clinicians must be well versed in all aspects of herpes zoster disease, including the clinical and laboratory diagnosis, as well as the incidence and presentation of herpes zoster. Current treatments, such as the use of famciclovir, acyclovir, valcyclovir, and prednisone, must also be understood.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
12/12. severe combined immunodeficiency with cartilage-hair hypoplasa: in vitro response to thymosin and attempted reconstitution.The present report describes an infant with severe combined immunodeficiency and cartilage-hair hypoplasia whose lymphocytes responded to thymosin in vitro. Immunologic evaluation was undertaken at 4 1/2 months of age following a history of recurrent severe infection. family history included three cousins who died in early infancy, one from streptococcal meningitis and pneumonia, one from generalized varicella, and another from reticuloendotheliosis. Quantitative immunoglobulins were markedly depressed: IgG 141, IgA 0, and IgM 24 mg/100 ml. There was an absolute lymphopenia, multiple skin tests were negative, and in vitro lymphocyte responses to mitogens and antigens were depressed. Spontaneous E rosette determinations were 21% compared with control values of 65.7%. Erythrocyte adenosine deaminase (ADA) activity was normal. The patient's E rosette formation increased in the presence of thymosin, fraction 5, reaching a maximum of 56% with a concentration of 500 mug thymosin. Blastogenic responses to phytohemagglutinin also increased in the presence of thymosin. Transplantation of 24-week fetal thymus in Millipore diffusion chambers and subsequently transplantation of 18-week fetal thymus by intraperitoneal injection was accomplished. E rosettes increased to 35-40% and blastogenic responses to mitogens increased. Eight days after the second transplant the patient underwent a mild graft vs. host reaction which subsided after 1 week and mitogen blastogenic responses again increased to 5-8 times previous values, but still well below control ranges. Repeated episodes of pulmonary infection ensued, cor pulmonale resulted, and the clinical course was relentlessly downhill with the patient expiring from respiratory failure 5 months after transplantation.- - - - - - - - - - ranking = 1keywords = varicella (Clic here for more details about this article) |
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