Two types of varicella zoster in one patient

Description

A 79-year-old patient, with a background of chronic lymphocytic leukaemia, presents with herpes zoster (HZ) affecting the left C2/3 dermatome (figure 1). Three days after initial development, a secondary diffuse vesicular papuloblistering rash developed on the trunk, resembling varicella zoster virus (VZV) infection (figure 2).

Figure 1

Vesicular plaque located to C2/3 dermatome.

Figure 2

Disseminated vesiculopapular lesions.

Vesicular fluid from both rashes was positive for VZV on Fast Track Diagnostic multiplex real-time PCR assay, which has a specificity of 100% and sensitivity of 100% to 10³ copies/mL dilution. Other methods of detection include directly with viral isolation and culture, detection of antigen in cell specimens, visualisation via light microscopy with Tzanck smears or electron microscopy or indirectly with western blotting or IgG detection.1 Further samples were sent for bacterial and fungal microscopy,...

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