Herpes zoster

The Genital, Perianal and Umbilical Regions

Background. Herpes zoster infection particularly involving the sacral dermatomes has been associated with bladder and bowel dysfunction, most commonly urinary retention.



Case Reports. We report two patients who developed acute urinary retention, one of whom also had constipation, within days of herpes zoster skin lesions of the S2-S4 dermatomes.



Conclusions. Herpes zoster is a reversible cause of neuro-genic bladder and bowel dysfunction and should be considered in a patient that presents with acute urinary retention and/or constipation. Sensory abnormalities and flaccid detrusor paralysis are most likely involved in the pathogenesis.

Urinary retention associated with herpes zoster infection.

Summary— Two cases of urinary retention and granulomatous prostatitis following sacral herpes zoster infection are described. This previously unrecognised association may be significant in the mechanism of retention in these cases.

Urinary Retention and Granulomatous Prostatitis Following Sacral Herpes Zoster Infection A Report of 2 Cases with a Review of the Literature

Objective: To compare the relative proportions of varicella zoster virus (VZV) and herpes simplex viruses in specimens obtained from the genital lesions of adults presenting with presumed genital herpes infection. Methods: Swabs of genital lesions from 6210 patients attending general practices, infectious diseases clinics within hospitals, or sexual health centres for treatment of their genital lesions were tested using polymerase chain reaction (PCR) technology. The multiplexed PCR was capable of detecting herpes simplex virus types 1 and 2 (HSV-1, HSV-2), VZV, and cytomegalovirus in a single sample. Results: A total of 2225 patients had viruses detected by PCR. HSV-1 was detected in 36%, HSV-2 in 61%, and VZV in 2.9% of PCR positive samples. Of the 65 patients with VZV genital infection, many were thought to have HSV infection before laboratory testing. Conclusions: The finding of VZV in nearly 3% of virus positive genital specimens demonstrates that this virus needs to be considered as a differential diagnosis for genital herpetic lesions. Advice provided to patients with VZV genital infection regarding the source of infection, likelihood of recurrence, and potential for transmission of the virus will be different from that given to patients with HSV infection.

https://sti.bmj.com/content/sextrans/79/4/298.full.pdf

Detection of varicella zoster virus in genital specimens using a multiplex polymerase chain reaction.

SUMMARY

Herpes zoster of the anogenital area is reported in six patients. The inability to urinate and to defaecate is a serious complication. This entity is well known in the urological but seemingly unreported in the dermatological literature. None of these patients had a recurrence of the herpes, nor did any have a known neoplasm.

Sidney B. Newman

Papers

Herpes zoster of the anogenital area affecting urination and defaecation