DANIEL J. ANDERSON, M.D.; EDWARD N. JANOFF, M.D.
To the editor: Corticosteroids are often prescribed for prevention of post-herpetic neuralgia in the elderly. We report a case of disseminated herpes zoster after prednisone treatment in a woman on low-dose methotrexate.
A 66-year-old woman, treated with methotrexate (2.5 mg orally every other day) for rheumatoid arthritis, presented with a 3-day history of severe pain associated with cutaneous zoster. She was given prednisone (30 mg/d) in an attempt to prevent post-herpetic neuralgia. On day 6 she received codeine for persistent, severe pain, and on day 8 she was hospitalized with fever, confusion, shortness of breath, and mild photophobia.
ANDERSON DJ, JANOFF EN. Herpes Zoster Infection in a Patient on Methotrexate Given Prednisone to Prevent Post-herpetic Neuralgia. Ann Intern Med. ;107:783. doi: 10.7326/0003-4819-107-5-783_1
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Published: Ann Intern Med. 1987;107(5):783.
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