Age: 75.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Polymerase chain reaction, Post herpetic neuralgia
Clinical narrative: Information has been received from a physician concerning a 76 year old female with pain and "allergies to some medications" and a history of cancer who on 11-OCT-2007 was vaccinated with a dose of Zostavax. Concomitant therapy included therapy unspecified ("VERTREX"). On 11-OCT-2007, the patient experienced shingles all over her face including mouth, ears, neck and in her hair, and excruciating pain on her shoulders and on her arms. The patient had diagnostic studies performed, "scrapings off of blister, blood test". The patient's shingles all over her face including mouth, ears, neck and in her hair and excruciating pain on her shoulders and arms persisted. Unspecified medical attention was sought. No product quality complaint. Follow-up information received from the physician from a herpes zoster questionnaire indicating that the patient had a medical history of childhood chickenpox, rectal cancer and the patient also has Paget's disease, hypothyroidism, and osteoporosis. The patient has allergies to most antibiotics, "Levbid", steroids, antihistamines, "Lyelle" and "anirphylose". The patient received Zostavax (lot# 657676/0619U) on 02-OCT-2007 in the left deltoid. The patient developed lesion of the right pre-auricular at approximately 2 cm in length and also in the right exterior ear canal. The dermatome was described as "trigeminal". Date of Herpes zoster was reported as 09-OCT-2007 (also previously reported as 11-OCT-2007). The patient was afebrile, pain was ranked 10 out of 10 (10 being the highest). The patient recovered with postherpatic neuralgia. There was no recent exposure to chickenpox or herpes zoster. The direct fluorescent antibody was not performed. The specimen collected for PCR was done on 12-Nov-2007 and no photo was taken. Additional information is not expected. This is in follow-up to report (s) previously submitted on 12/21/2007.  Follow-up information received on 17-DEC-2007 indicated the patient was vaccinated intramuscularly at 14:30 hours with a dose of ZOSTAVAX vaccine (Merck). There were no illnesses at the time of vaccination . On 14-OCT-2007 the patient was seen in the emergency department with a right scalp vesicular rash and was treated with VALTREX. It was also reported the patient had severe pain in her right external ear canal with vesicles and was treated with NORCO, gabapentin and amitriptyline. On 14-OCT-2007 the patient had herpes culture. On 29-OCT-2007 the patient had a varicella zoster IgM 0.57 and IgG 12.0. The onset date for the herpes zoster was updated to 14-OCT-2007 (previously reported 11-OCT-2007). At the time of the report the patient's status was not recovered. The patient was enrolled in the varicella zoster virus identification program to identify if VZV is present and if it is present to identify if it is associated with the wild-type (WT) VZV strain or with the Merck VZV strain. The sample of the lesion was collected on 12-NOV-2007. The sample was taken from the right ear and chin (scab scrapings). The PCR results for the specimen from the chin identified the presence of VZV WILD TYPE STRAIN. Additional information is not expected.