Case report:
A 66-year-old female, with a history of arterial hypertension, was admitted to the infectious diseases department for vesicular eruption associated with a severe pain on her right side of the face. She reported that she received her first dose of AstraZeneca COVID-19 vaccine 5 days ago. No other symptoms such as fever, dyspnea or cough were accompanied. The physical examination revealed: a temperature of 37 °C, heart rate 92 beats per minute, respiratory rate 16 breaths per minute, blood pressure 120/70 mmHg and Glasgow coma score of 15. The vesicular lesions contained purulent fluid upon an erythematous base and were localized in the right cheek, side of nose and upper lip, associated with palpebral edema (Figure1). The oral mucosa was intact.
The biological findings of the serum showed: blood cell counts, renal and hepatic functions within normal limits and an elevated c-reactive protein (35 mg/L). The serological tests of Human Immunodeficiency Virus (HIV) 1 and 2 were negative. The patient didn’t report the use of immunosuppressive drugs or coticosteroid therapy, a history of malignancy, physical trauma or psychological stress. The diagnosis of herpes zoster in the rignt maxillar branch of trigeminal nerve with bacterial superinfection was made based on the clinical dermatomal presentaton of the lesions. Antiviral treatment was started with acyclovir 750mg thrice daily for 10 days associated with antibiotic treatment: amoxicillin-clavulanic acid 1gr three times a day for a week to treat the bacterial superinfection. The outcome was favourable unless a moderate postherpetic neuralgia.