Herpes zoster of the nipple: rapid DNA-based diagnosis by the loop-mediated isothermal amplification method

Cytopathological Diagnosis of Herpes Simplex Viral Mastitis: Three Rare Cases and a Review of the Literature

Context:

Virus infection has a unique morphological change in cell pathology. It is also of great significance in the diagnosis of herpes simplex mastitis.

Aims:

To evaluate the practicability and feasibility of cytological diagnosis of herpes simplex virus mastitis.

Materials and Methods:

Three cases of HSV mastitis diagnosed by cytology smears were collected. The papules were stained with Wright-Giemsa to observe the morphological characteristics of the cells.

Statistical Analysis:

The cytological characteristics of 3 cases were summarized and compared with the literature.

Results:

In the background of inflammatory cells in the smear, the cells with characteristic changes can be seen in the mass and scattered distribution. The nuclear size increased significantly, and mononuclear, binuclear, trinuclear and multinuclear nuclei appeared. The nuclei of multinuclear were crowded and mosaic. The chromatin of nucleus changed like frosted glass, and the chromatin became thicker at the edge of nucleus. Inclusion bodies were found in the nucleus, eosinophilic, with different sizes and irregular shapes. These characteristics are helpful to distinguish from other lesions.

Conclusion:

Scraper cytology is a diagnostic tool with simple operation, small trauma and pain, and it has important application value in the differential diagnosis of HSV infection, which deserves the attention of clinicians.

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Background

Herpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.

Methods

We searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.

Results

From 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.

HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.

Conclusions

Several countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.

Electronic supplementary material

The online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.