Trigeminal herpes zoster: early recognition and treatment are crucial

Reactivation of varicella zoster virus (VZV) is not uncommon in older patients, particularly in cases of chronic autoimmune disorders and in patients taking immunosuppressant drugs. We present a case of a 57-year-old woman presenting with severe herpes zoster infection, involving the maxillary and ophthalmic branches of the trigeminal nerve. Despite an initial delay in instigating crucial antiviral treatment, the patient achieved an excellent recovery, with only some mild scarring at 2 months postinfection. Trigeminal herpes zoster is a potentially devastating clinical occurrence, and is associated with severe long-term neurological sequelae, including encephalitis, vision loss and postherpetic neuralgia. Physicians must be aware of risk factors and treatment modalities.