Abstract
The case report describes manifestation and course of herpes zoster disease diagnosed in a geriatric patient. The initial diagnosis showed herpes zoster infection involving mandibular branch of the trigeminal nerve with facial nerve palsy.
Geriatric age increases the risk of developing the disease, as well the development of the postherpetic neuralgia. In old age the herpetic infection often indicates a serious systemic disease and further diagnostics are required.
Initial symptomatology of the herpes zoster disease is not pathognomonic, and it can be mistaken for other symptoms of a different disease and even if it is eventually determined, the exact identification of the affected branch in the case of a cranial nerve infection may remain uncertain. Related complications documented in the case report were accompanied by chronic pain and reduced food intake leading to malnutrition and consequently to infectious complications and the patient's fall.
It can be assumed that the underlying patient's disease led to reactivation of the herpes infection, but the subsequent clinical development was also modified by chronic lymphocytic leukaemia diagnosed ex post. Vaccination of geriatric patients against herpes zoster can be a significant contribution to improving the quality of life as is clear from our case report and can prevent many subsequent complications.
For wider use it seems that vaccinating patients with recombinant vaccination is an optimal alternative for the future.