以咽喉潰瘍表現之帶狀皰疹－病例報告

Herpes Zoster Infection Presenting with Pharyngolaryngeal Ulcers: A Case Report

江純豪(Chun-Hao Chiang) ； 許家禎(Chia-Chen Hsu)

《北市醫學雜誌》 16卷2期 (2019/06) Pp. 157-161

https://doi.org/10.6200/TCMJ.201906_16(2).0007

摘要

患有糖尿病和高血壓的67歲女性，因劇烈左側喉嚨痛，到院求診。理學檢查與內視鏡檢查發現左側軟顎、下咽及喉部，出現多處潰瘍，懷疑咽喉部水痘帶狀皰疹感染，在給予抗病毒藥物及廣效型抗生素治療後，症狀改善，血清學抗體檢驗證實為水痘帶狀皰疹感染。臨床上醫護人員應對咽喉潰瘍鑑別診斷有所了解，病因包含病毒感染、黴菌感染、多形性紅斑、化療相關潰瘍、某些自體免疫疾病和惡性腫瘤等。侵犯喉部的水痘帶狀皰疹，要當心其併發症之發生，如吞嚥困難、發聲障礙等，併發症在疾病緩解後，不一定會完全恢復，宜事先和病人溝通，並持續追蹤觀察。

關鍵字

咽喉潰瘍 ； 咽喉帶狀皰疹 ； 單側喉嚨痛

並列摘要

A female with a history of type 2 diabetes mellitus and hypertension came to our outpatient department because of severe sore throat on left side for 5 days. The physical examination revealed multiple ulcers on the left side of soft palate, pharynx, and larynx. The symptoms improved after antiviral medication and antibiotics therapy under the impression of varicella-zoster virus (VZV) infection of the pharynx and larynx. The positive serology test of IgG and IgM antibodies to VZV finally proved the pharyngolaryngeal VZV infection. Multiple pharyngeal ulcers are caused by viral infection, fungal infection, erythema multiforme, chemotherapy related ulcers, some autoimmune diseases, cancers, and so on. In patients with pharyngolaryngeal involvement of VZV, attentions should be paid on possible emergement of complications like dysphagia, voice disturbance, and so on. The complications may not recover after adequate therapy. The patient should be informed about the disease prognosis at the time of diagnosis.

並列關鍵字

pharyngolaryngeal ulcer ； pharyngolaryngeal zoster ； unilateral throat pain