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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2025
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| _version_ | 1864513533263216640 |
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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 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| 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 |