A study of post-traumatic shingles as a work related injury

Background After chicken pox, the herpes varicella-zoster (HVZ) virus may r emain dormant in the dorsal root ganglion until later reactivation causes s hingles, characterized by painful dysesthesias and cutaneous vesicular erup tions along a unilateral dermatome. Shingles as a work-related injury has n ot been previously addressed in the medical literature. Case History We present a 50-year old female hospital employee who, while w orking, sustained an acute, traumatic hyperextension injury to her right wr ist, hand, and fingers. Although she initially responded to treatment for f lexor tendinitis, she suddenly developed shingles in the right C5-C6 dermat omes. She was treated with famcyclovir and her skin lesions resolved, but p ost-herpetic neuralgia persisted. Conclusions It was felt that her shingles was causally related to her occup ational injury since trauma (previously reported to precipitate shingles) w as her only risk factor and the timing and location of the lesions correspo nded closely to the occupational injury. In addition to appropriately diagn osing and treating their patients, workers' compensation physicians often m ust determine if a particular condition was caused by the original work-rel ated incident. Clinicians who treat trauma patients and injured workers sho uld be aware of post-traumatic shingles and understand the causal relations hip of this uncommon but clinically important phenomenon. Am. J. Ind. Med. 38:108-111, 2000. (C) Wiley-Liss, Inc.