Orofacial manifestation of herpes zoster: case reports

Abstract

Objective: This study aims to review the current literature on the diagnosis and treatment of Herpes zoster (HZ) and to report two clinical cases treated at the Regional Hospital of Agreste, highlighting the importance of differential diagnosis with odontogenic infections. Case report: The first case concerns a 25-year-old male who initially presented with suspected odontogenic infection but was later diagnosed with HZ involving the V3 dermatome and tested positive for HIV. The second case describes a 52-year-old male with lesions affecting the V1 and V2 dermatomes and decreased visual acuity, also diagnosed with HZ and HIV infection. Both patients received intravenous acyclovir, antibiotics, and supportive care, resulting in significant clinical improvement. Conclusion: HZ can be the first clinical sign of immunosuppression, particularly in HIV-positive individuals, emphasizing the need for early diagnosis and multidisciplinary management. Accurate differentiation between viral and odontogenic infections is crucial for appropriate treatment. Preventive vaccination and early antiviral therapy are essential to minimize complications such as postherpetic neuralgia and neurological sequelae. Advances in antiretroviral therapy have improved the prognosis of immunocompromised patients affected by HZ.