Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report

<h3>Background</h3><p dir="ltr">Herpes zoster can affect the cranial nerves but rarely it involves the glossopharyngeal nerve in isolation. Varicella zoster virus (VZV) infection most often occurs in the context of previous varicella infection, but it is exceedingly rare...

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Main Author: Mavia Najam (15954224) (author)
Other Authors: Ahmed Noor (22150198) (author), Shahzad Anjum (21245285) (author), Haris Iftikhar (15954223) (author)
Published: 2025
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author Mavia Najam (15954224)
author2 Ahmed Noor (22150198)
Shahzad Anjum (21245285)
Haris Iftikhar (15954223)
author2_role author
author
author
author_facet Mavia Najam (15954224)
Ahmed Noor (22150198)
Shahzad Anjum (21245285)
Haris Iftikhar (15954223)
author_role author
dc.creator.none.fl_str_mv Mavia Najam (15954224)
Ahmed Noor (22150198)
Shahzad Anjum (21245285)
Haris Iftikhar (15954223)
dc.date.none.fl_str_mv 2025-08-21T06:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.jemermed.2025.08.032
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Isolated_Glossopharyngeal_Nerve_Herpes_Zoster_Infection_Following_Varicella_Vaccination_in_an_Emergency_Physician_A_Case_Report/30018751
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Immunology
Neurosciences
Herpes zoster
cranial nerve
glossopharyngeal
Varicella
Vaccination
Physician
Case Report
dc.title.none.fl_str_mv Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Herpes zoster can affect the cranial nerves but rarely it involves the glossopharyngeal nerve in isolation. Varicella zoster virus (VZV) infection most often occurs in the context of previous varicella infection, but it is exceedingly rare in immunocompetent vaccinated patients without previous infection. </p><h3>Case Report</h3><p dir="ltr">We report a unique case of a 34-year-old immunocompetent male presenting with severe throat pain, odynophagia, and headache, accompanied by vesicles on the left side of hard and soft palate, base of the tongue, and the posterior pharyngeal wall. Notably, the patient had no history of chickenpox but had previous varicella vaccination. Polymerase chain reaction analysis (PCR) from the throat swab confirmed varicella-zoster virus infection. Antiviral therapy and aggressive pain management led to symptom resolution. However, the patient developed nausea, anorexia, intractable hiccups and cough lasting several days. </p><h3>Why should an emergency physician be aware of this? </h3><p dir="ltr">This case highlights the importance of considering herpes zoster in atypical cranial nerve presentations, raises questions about the pathogenesis of herpes zoster reactivation following live vaccination, and emphasizes the need for prompt recognition and treatment to prevent complications.</p><h2>Other Information</h2><p dir="ltr">Published in: The Journal of Emergency Medicine<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jemermed.2025.08.032" target="_blank">https://dx.doi.org/10.1016/j.jemermed.2025.08.032</a></p>
eu_rights_str_mv openAccess
id Manara2_090fc4288a130bf0272a1c7283d7a846
identifier_str_mv 10.1016/j.jemermed.2025.08.032
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/30018751
publishDate 2025
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spelling Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case ReportMavia Najam (15954224)Ahmed Noor (22150198)Shahzad Anjum (21245285)Haris Iftikhar (15954223)Biomedical and clinical sciencesClinical sciencesImmunologyNeurosciencesHerpes zostercranial nerveglossopharyngealVaricellaVaccinationPhysicianCase Report<h3>Background</h3><p dir="ltr">Herpes zoster can affect the cranial nerves but rarely it involves the glossopharyngeal nerve in isolation. Varicella zoster virus (VZV) infection most often occurs in the context of previous varicella infection, but it is exceedingly rare in immunocompetent vaccinated patients without previous infection. </p><h3>Case Report</h3><p dir="ltr">We report a unique case of a 34-year-old immunocompetent male presenting with severe throat pain, odynophagia, and headache, accompanied by vesicles on the left side of hard and soft palate, base of the tongue, and the posterior pharyngeal wall. Notably, the patient had no history of chickenpox but had previous varicella vaccination. Polymerase chain reaction analysis (PCR) from the throat swab confirmed varicella-zoster virus infection. Antiviral therapy and aggressive pain management led to symptom resolution. However, the patient developed nausea, anorexia, intractable hiccups and cough lasting several days. </p><h3>Why should an emergency physician be aware of this? </h3><p dir="ltr">This case highlights the importance of considering herpes zoster in atypical cranial nerve presentations, raises questions about the pathogenesis of herpes zoster reactivation following live vaccination, and emphasizes the need for prompt recognition and treatment to prevent complications.</p><h2>Other Information</h2><p dir="ltr">Published in: The Journal of Emergency Medicine<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jemermed.2025.08.032" target="_blank">https://dx.doi.org/10.1016/j.jemermed.2025.08.032</a></p>2025-08-21T06:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.jemermed.2025.08.032https://figshare.com/articles/journal_contribution/Isolated_Glossopharyngeal_Nerve_Herpes_Zoster_Infection_Following_Varicella_Vaccination_in_an_Emergency_Physician_A_Case_Report/30018751CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/300187512025-08-21T06:00:00Z
spellingShingle Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report
Mavia Najam (15954224)
Biomedical and clinical sciences
Clinical sciences
Immunology
Neurosciences
Herpes zoster
cranial nerve
glossopharyngeal
Varicella
Vaccination
Physician
Case Report
status_str publishedVersion
title Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report
title_full Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report
title_fullStr Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report
title_full_unstemmed Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report
title_short Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report
title_sort Isolated Glossopharyngeal Nerve Herpes Zoster Infection Following Varicella Vaccination in an Emergency Physician: A Case Report
topic Biomedical and clinical sciences
Clinical sciences
Immunology
Neurosciences
Herpes zoster
cranial nerve
glossopharyngeal
Varicella
Vaccination
Physician
Case Report