Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea

Cho, Sung-Yeon; Lee, Hyeon-Jeong; Lee, Dong-Gun

Herpes zoster is caused by the reactivation of virus latent in the posterior ganglia after primary infection with varicella zoster virus (VZV). In Korea, VZV is transmitted by natural infection in most cases and its seroprevalence in adults is > 90%; previous VZV infection is a prerequisite for herpes zoster [98] [99] [100] . The clinical features of herpes zoster include abnormal sensation or pain through skin segments 2 to 3 days before skin lesions develop, erythematous spots with irritation, and rapid formation of blisters. The blisters burst and form ulcers, which scar and become dry. Pain and postherpetic neuralgia are major problems. In most cases, one or two dermatomes are involved unilaterally, but dissemination to several other dermatomes or systemically can occur and is associated with visceral or central nervous system involvement [101] . Treatment consists of antiviral administration and adjuvant therapy to reduce the acute pain and postherpetic neuralgia. It is not clear whether antiviral treatment is effective 72 hours after the onset of rash. However, immunocompromised patients with persistent or new vesicular rash, eye involvement, and/or neurologic complications should receive antiviral treatment even > 72 hours after the onset [1] .