Elsevier

Auris Nasus Larynx

Volume 36, Issue 5, October 2009, Pages 606-608
Auris Nasus Larynx

Herpes zoster laryngitis with intractable hiccups

https://doi.org/10.1016/j.anl.2009.01.011Get rights and content

Abstract

A 73-year-old man presented to our hospital with a sore throat (left-sided) and hiccups. The patient had mucosal swelling and erosions affecting the left posterior pillar, base of tongue, epiglottis, arytenoid, and aryepiglottic fold. As the laryngeal mucosal edema became worse, herpetic vesicles and erosions developed on the left cavum conchae, external auditory canal, and palate. The patient was treated with acyclovir and a steroid. His hiccups were treated with metoclopramide, but it had little effect, and hiccups only subsided gradually after the disappearance of erosions. His hiccups relapsed transiently with vomiting, and then resolved completely. Elevation of the CF titer after 2 weeks confirmed the diagnosis of herpes zoster. This condition should be considered in patients with unilateral sore throat and intractable hiccups, and treatment with acyclovir should be provided.

Introduction

Herpes zoster is caused by reactivation of latent varicella-zoster virus infection [1]. It is often associated with impaired immunity or stress, and is characterized by unilateral herpetic vesicles and neuralgia [2], [3]. Herpes zoster of the laryngeal region is rare [2], [3], [4], [5], [6], [7], [8], and zoster associated with hiccups is also rare [9], [10], [11], [12]. A 73-year-old man who suffered from herpes zoster laryngitis associated with hiccups is presented here. This is the first report about the combination of laryngeal zoster and hiccups.

Section snippets

Case report

A 73-year-old man with a left-sided sore throat and intractable hiccups for 2 days was referred to the otorhinolaryngological department. The patient had mucosal swelling and erosions on the left posterior pillar, base of tongue, epiglottis, arytenoid, and aryepiglottic fold. He had a history of glaucoma, prostatic hypertrophy, inguinal hernia, intervertebral disk hernia, resting angina pectoris, hyperlipidemia, hyperuricemia, and herpes zoster of the left chest. He had no history of diabetes

Discussion

Herpes zoster is a common disease caused by reactivation of dormant varicella-zoster virus in the dorsal root ganglia, which may affect motor and/or sensory nerves. The prodromal symptoms include pain, a burning sensation, and tingling, which are followed by the eruption of vesicles. Herpes zoster is characterized by the unilateral distribution of the vesicles and neuralgia. Herpes zoster oticus occurs when reactivation of varicella-zoster virus infection involves the trigeminal nerve, facial

Conclusions

A rare case of herpes zoster laryngitis with intractable hiccups was presented. It is necessary to remember and identify herpes zoster, so that early treatment can be provided.

References (15)

  • J.A. Pinto et al.

    Laryngeal herpes: a case report

    J Voice

    (2002)
  • A.L. Berlin et al.

    Hiccups eructation, and other uncommon prodromal manifestations of herpes zoster

    J Am Acad Dermatol

    (2003)
  • H. Hirose et al.

    Herpes zoster oticus (in Japanese)

  • C.L. Wu et al.

    Herpes zoster laryngis with prelaryngeal skin erythema

    Ann Otol Rhinol Laryngol

    (2004)
  • H. Yaguchi et al.

    Case of zoster sine herpete presenting with dysphagia diagnosed by PCR analysis of VZV DNA in auricular skin exudated (in Japanese)

    Rinsho Shinkeigaku

    (2006)
  • A. Maeda et al.

    A case of multiple cranial nerve palsy with severe dysphagia due to herpes zoster infection (in Japanese)

    Rinsho Shinkeigaku

    (1992)
  • F. Hiraide et al.

    Acute profound deafness in Ramsay Hunt Syndrome. Two case reports

    Acta Otolaryngol (Stockh) Suppl

    (1988)
There are more references available in the full text version of this article.

Cited by (0)

View full text