Pain Management of Post-Herpetic Neuralgia in Disseminated Herpes Zoster
A 72 yo female with a history of chronic lymphatic leukemia on ibrutinib presented to the clinic with post herpetic neuralgia and left foot weakness. She had a prolonged hospital course after initially presenting with acute urinary retention and an erythematous vesicular rash on her left sacrum and posterior proximal thigh in the S1 distribution. Antibiotics were started for suspected urinary tract infection, but labs were negative for infection. Her urinary retention was ultimately attributed to neuropathic effects of acute disseminated herpes zoster. She was treated with acyclovir, long term Foley catheter, gabapentin, amitryiptyline, and a caudal epidural spinal injection.
Zhang J, Chokr M, Clemans RR. Pain management of post-herpetic neuralgia in disseminated herpes zoster. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/4751