Atypical disseminated herpes zoster infections in patients with demyelinating disease treated with dimethyl fumarate

Alexandra Balshi; John Dempsey; Jacob A Sloane

doi:10.1007/s13365-024-01230-x

Atypical disseminated herpes zoster infections in patients with demyelinating disease treated with dimethyl fumarate

J Neurovirol. 2024 Oct 21. doi: 10.1007/s13365-024-01230-x. Online ahead of print.

Authors

Alexandra Balshi¹, John Dempsey¹, Jacob A Sloane²

Affiliations

¹ Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA, 02215, USA.
² Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Kirstein 215, Boston, MA, 02215, USA. jsloane@bidmc.harvard.edu.

PMID: 39433711
DOI: 10.1007/s13365-024-01230-x

Abstract

We report two patients who developed atypical, disseminated herpes zoster infections while on dimethyl fumarate (DMF) treatment, one with varicella zoster virus (VZV) encephalitis and another with herpes zoster oticus resulting in lasting motor and sensory deficits. We recommend vaccination against VZV prior to DMF initiation be incorporated as standard of care, as ensuring patients are protected against VZV before starting DMF can prevent such severe outcomes.

Keywords: Disseminiated shingles; Herpes zoster; Multiple sclerosis; Shingles; Varicella.