While it usually happens on one side of the body, in this case, it manifested bilaterally, which is extremely rare. The lesions formed on both sides of the face, including around the forehead, cheeks, and eyes, which is highly unusual in someone in relatively healthy condition
The patient's fever abated, and rashes resolved without secondary infection; her general condition stabilised. Photo Courtesy: Manipal Hospitals, Broadway
A team of doctors in Kolkata have successfully treated a rare instance of bilateral Herpes Zoster in a 74-year-old woman, Nanda Ghosh. This is only the fourth documented case of bilateral Herpes Zoster in the country involving a patient who is not immunocompromised. She was brought to Manipal Hospitals, Broadway with complaints like fever, high-grade headache, nasal discharge, congestion, and coughing, Upon examination, vesiculopapular rashes (small bumps or fluid-filled blisters) among other symptoms suggested a severe and rare presentation of the Herpes virus.
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The woman was suffering from days of fever, unceasing headache, and pain so inexplicable it just won't subside. Despite a growing sense that something is seriously wrong, the underlying cause remained unknown. Such was the condition of this elderly patient till her son brought her to the hospital where finally her condition found a diagnosis and treatment.
Herpes Zoster, commonly known as shingles can cause painful rashes and typically forms along a single nerve root (dermatome) on one side of the body, often affecting areas like the chest, abdomen, or face. However, in this case, it manifested bilaterally, which is extremely rare. The lesions formed on both sides of the face, including around the forehead, cheeks, and eyes, which is highly unusual in someone in relatively healthy condition.
A multidisciplinary team led by Dr Partha Sarathi Bhattacharjee, consultant - internal medicine, at the hospital confirmed the diagnosis through an extensive investigation. The patient was treated with antiviral medication (Zovirax) to target the Herpes virus and antibiotics (Meropenem) to manage secondary bacterial infections. Dermatologists and ophthalmologists were consulted to ensure comprehensive care.
Dr Bhattacharjee explained, “This case was a medical rarity, especially in a healthy elderly individual without immunosuppression. Such cases challenge conventional medical understanding and require advanced diagnostic expertise. If left untreated, Herpes Zoster can lead to severe complications such as blindness, hearing loss, and nerve damage. Getting the shingles vaccine can prevent herpes outbreaks. The shingles vaccine is administered in a 2-dose series, with the second dose given 2 to 6 months after the first for optimal effectiveness. Timely diagnosis and treatment are essential in managing the condition and preventing complications. While this vaccine is recommended for all ages, this is particularly beneficial for the elderly or those at higher risk.”
Nanda’s son shared his emotional journey, stating, “Watching my mother suffer without knowing what was wrong was heart-wrenching. This is the fourth time we have relied on Manipal Hospitals, Broadway, and every time, they have exceeded our expectations. My mother's condition was critical and very unusual, but the doctors here handled it with extraordinary care and expertise. Thanks to their efforts, my mother is now back home with her family. We are deeply thankful.”
In a week, the patient showed great improvement under the care of the hospital. Her fever abated, and rashes resolved without secondary infection; her general condition stabilised. The patient was discharged in ten days with overall good health and immense gratitude regarding the compassionate and highly professional treatment.
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