Herpes zoster complicated by phrenic nerve palsy and respiratory compromise

Afr Health Sci. 2019 Sep;19(3):2347-2350. doi: 10.4314/ahs.v19i3.6.

Abstract

Background: Herpes zoster can be associated with severe neurological complications.

Case presentation: In this article, we describe the case of a 54-year-old man with herpes zoster affecting his right upper chest and neck region complicated by phrenic nerve palsy and respiratory compromise. The diagnosis of herpes zoster was made based on the classic appearance of the rash and associated neuropathic-type pain. The diagnosis of phrenic nerve palsy was made by chest x-ray and ultrasound.

Conclusion: Clinicians should be aware of the possibility of phrenic nerve palsy occurring in patients who have herpes zoster affecting the region of C3,4,5 dermatomes. Although symptoms of unilateral diaphragmatic paresis are usually mild, in patients with obesity or comorbid lung disease, new onset phrenic nerve palsy can lead to significant respiratory compromise.

Keywords: Herpes zoster; case report; neurologic complication; phrenic nerve palsy.

Publication types

  • Case Reports

MeSH terms

  • Fatal Outcome
  • Herpes Zoster / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Paralysis / complications*
  • Paralysis / microbiology*
  • Peripheral Nervous System Diseases / microbiology*
  • Phrenic Nerve / physiopathology*
  • Respiratory Insufficiency / complications*
  • Respiratory Insufficiency / microbiology*