A suspected dental cellulitis leading to diagnosis of both herpes zoster ophthalmicus and HIV

Abstract

Herpes zoster ophthalmicus and HIV are serious health problems. We report a case of a 37-year-old woman who presented to the Korle-Bu Teaching Hospital with dyspnea and facial cellulitis, and a diagnosis 5 days prior of dental cellulitis made at a district hospital. Investigations revealed that the facial cellulitis was secondary to herpes zoster infection involving the ophthalmic division of the left trigeminal nerve. The patient responded well to oral acyclovir but developed postherpetic neuralgia. During the course of treatment, she was also diagnosed to be HIV-1 positive and was referred for further management. This case represents a unique report in which the patient presented to the hospital with symptoms of cellulitis suggestive of underlying dental infection but was later diagnosed with both herpes zoster ophthalmicus and an underlying HIV infection. Atypical presentations of herpes zoster can occur in HIV/AIDS. Signs of herpes zoster infection with cellulitis should alert the clinician that the patient may have a possible underlying immunosuppressive disease. The population must be educated regarding the importance of early presentation and careful compliance with treatment as well as regular follow-ups.

Keywords

• Herpes zoster
• Ophthalmic nerve
• HIV
• Dental cellulitis
• Post herpetic neuralgia
• Immunosuppressive disease