Herpes Zoster Induced Alveolar Bone Necrosis in Immunocompromised Patients; Two Case Reports

Document Type: Case Report

Authors

1 Oral and Maxillofacial Disease Research Center, Dental Faculty, Mashhad University of Medical Science, Mashhad, Iran.

2 Department of Oral and Maxillofacial Surgery, Dental Faculty, Mashhad University of Medical Science, Mashhad, Iran.

3 Department of Oral and Maxillofacial Medicine, Dental Faculty, Mashhad University of Medical Science, Mashhad, Iran.

4 Dentistry Research Center, Dental Faculty, Golestan University of Medical Science, Gorgan, Iran.

Abstract

Introduction:
Herpes zoster Infection (HZI) is a viral disease with painful skin rashes and blisters in a limited area on one side of the body, often in a strip. Osteonecrosis with spontaneous exfoliation of teeth in association with HZI of the mandibular nerve is a rare phenomenon. In this report, such an unusual complication of HZI is presented.
 
Case Report:
The clinical course of a 53-year-old woman and a 54-year-old man with HZI associated with alveolar bone necrosis and tooth exfoliation were reviewed in order to develop a patient profile for this rare combination of physical findings.
 
Conclusion:
In immunocompromised patients, the clinicians should consider HZI as a possible cause of tooth mobility, exfoliation, and alveolar osteonecrosis, which needs early intervention to prevent secondary complications.

Keywords

Main Subjects


1. Johnson RW, Dworkin RH. Clinical review: Treatment of herpes zoster and postherpetic neuralgia. BMJ. 2003;748-50.

2. Kennedy PG. Varicella-zoster virus latency in human ganglia. Rev Med Virol 2002; 12 (5): 327–34.

3. Peterslund NA. Herpesvirus infection: an overview of the clinical manifestations. Scand J Infect Dis Suppl 1991; 80(23): 15–20.

4. Gilden DH, Cohrs RJ, Mahalingam R. Clinical and molecular pathogenesis of varicella virus infection. Viral Immunol 2003 16 (3): 243–58.

5. Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, et al. Recommendations for the management of herpes zoster. Clin Infect Dis 2007; 44 suppl 1: s1–s26.

6. Cunningham AL, Breuer J, Dwyer DE, Gronow DW, Helme RD, Litt JC, et al. The prevention and management of herpes zoster. Med J Aust 2008; 188 (3): 171–6.

7. Owotade FJ, Ugboko VI, Bamidele K. Herpes zoster infection of maxilla. J Oral Maxillofac Surg 1999; 57(10): 1249-51.

8. Mendieta C, Miranda J, Brunet LI, Gargallo J, Berini L. Alveolar bone necrosis and tooth exfoliation following herpes zoster infection: a review of the literature and case report. J Periodontal 2005; 76(1): 148-53.

9. Ramchandani PL, Mellor TK. Herpes zoster associated with tooth resorption and periapical lesions. Br J Oral Maxillofac Surg 2007; 45(1):71-3.
10.
Jain MK, Manjunath KS and Jagadish SN. Unusual oral complications of herpes zoster infection:

Report of a case and review of literature. OralSurg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: e37-e41.

11. Delbrouck-Poot F, Reginster JP. Trigeminal herpes zoster and maxillary necrosis. Dermatologica 1979;158: 210-3.

12. Volvoikar P, Patil S, Dinaker A. Tooth exfoliation, osteonecrosis and neuralgia following herpes zoster of trigeminal nerve. Ind J Dent Res 2002; 13(1): 11-14.

13. Mahima VG, Patil K, Srikanth HS. Herpes zoster induced alveolar necrosis in an immunocompetent patient. Iranian J Clin Inf Dis 2010; 5(4): 235-8.