A Case of Gangrenous Herpes Zoster Complicated with Candida albicans Infection

BACKGROUND: Herpes zoster is a disease caused by varicella-zoster virus infection, which is characterized by dense clusters of vesicles distributed along unilateral bands of nerves and accompanied by neuralgia. Although the disease is self-limited, some patients may develop neurological, ocular, skin, or visceral complications. CASE PRESENTATION: We report a 65-year-old Chinese man with ulceration secondary to cutaneous blister rupture on the left lumbar abdomen, who was diagnosed with herpes zoster and did not respond to conventional treatment. Dermatological examination showed diffuse dark erythema with clear boundaries on his left waist and abdomen. Deep ulcers of different sizes were densely distributed with steep edges and relatively dry base, while yellow secretions and black scabs could be seen. Fungal microscopy showed a few pseudohyphae and clusters of spores. Meanwhile, the fungal culture of the secretions showed Candida albicans growth. Skin biopsy of the affected skin from the ulcer of the left abdomen revealed epidermal absence and clusters of spores in the superficial dermis. PAS staining was positive. The patient was diagnosed with gangrenous herpes zoster complicated with Candida albicans infection. After antifungal treatment based on the results of drug sensitivity, the patient’s condition was improved. CONCLUSION: This case reveals the co-existence of herpes zoster and Candida albicans infection, expands our understanding of overlapping diseases, and provides value for clinical diagnosis and treatment.