Complicated Herpes Zoster: Literature Review and Clinical Case Report

Herpes zoster (HZ) results from reactivation of latent varicella-zoster virus (VZV) in sensory ganglia. Facial involvement and neurological complications—including postherpetic neuralgia, peripheral facial paralysis, and severe ocular involvement—account for most of the associated morbidity and mortality. The adjuvanted recombinant vaccine has transformed prevention strategies in adults aged ≥ 50 years and immunocompromised individuals aged ≥ 19 years. However, gaps persist in the early diagnosis of atypical forms, risk stratification for postherpetic neuralgia (PHN), and equitable access to immunization in middle-income regions, including Latin America. We present the case of a female patient in her fourth decade of life, with a history of HIV infection, who presented with painful blistering and desquamative lesions of five days’ evolution, with severe involvement. The patient showed an adequate clinical response to the instituted medical treatment with acyclovir. This review synthesizes recent evidence on this infectious disease, which remains a frequent health concern in geriatric and vulnerable populations.