Citations 2
L5 Motor Paresis and Foot Drop Following Herpes Zoster Reactivation: An Unusual Presentation and Diagnostic Challenge in an Immunocompetent Patient - A Case Report
Romero, Tachy V. Hernandez, Ahmad, Ridwan , Orasma, Carlos A. Ruiz, Carcamo, Zulma D Sosa , Elwasila, Sammer M , Munipalli, Bala , Iftikhar, Salma , Gonzalez, Hector A. Robles, Dimberg, Elliot L., Alvarado, Joan M Irizarry , Rosales, J. Calvo , Hernandez Romero, Tachy V, Sosa Carcamo, Zulma D, Robles Gonzalez, Hector A, Irizarry Alvarado, Joan M , Cardenas Rosales, Juan Carlos , Orasma, Carlos Ruiz
Journal of Primary Care & Community Health | June 12, 2026 | Volume: 17 | Issue: No issue available | Pages: No page available
This is the case of a 67-year-old immunocompetent Hispanic male residing in Mexico who presented with acute right lower back and right lateral thigh pain. Initial imaging was unremarkable. He later developed painful vesicular lesions on the right foot and buttock. He was diagnosed with herpes zoster and initiated acyclovir and gabapentin. Ten days later, he developed foot drop, leg weakness, and urinary incontinence. Magnetic resonance imaging (MRI) showed enhancement of the cauda equina, and electrodiagnostic studies demonstrated right lumbar polyradiculopathy. The patient improved significantly with pain medications and physical therapy. After 8 months of physical therapy, he demonstrated significant clinical improvement. This case highlights the uncommon presentation of motor involvement in herpes zoster and emphasizes the role of imaging and electrophysiology in guiding diagnosis and management.
Acquired Angioedema as the First Sign of Lymphoproliferative Disorder: Case Report and Review of Literature
Rosales, J. Calvo , Ridwan, Ahmad, Ruiz-Orasma, Carlos, Galeano-Lovera, Santiago F. , López, Fernando Gil, Perusina, Jhonny, Squire, Jacqueline D. , Jiang, Liuyan , Moustafa, Muhamad Alhaj , Harris, Dana M. , Iftikhar, Salma , Munipalli, Bala , Cardenas Rosales, Juan Carlos , Gil Lopez, Fernando, Moustafa, Muhamad Alhaj , Harris, Dana M , Ridwan, Ahmad, Gil-López, F. Santoyo, Squire, Jacqueline
Journal of Primary Care & Community Health | July 31, 2025 | Volume: 16 | Issue: No issue available | Pages: No page available
Acquired angioedema due to C1-inhibitor deficiency (AAE-C1INH) is a rare condition characterized by the localized swelling of the deeper skin layers and mucous membranes, especially the face, lips, tongue, throat, and gastrointestinal tract. AAE-C1INH is strongly associated with lymphoproliferative disorders, although it can also be linked to autoimmune conditions, solid tumors, infections, or even occur without an identifiable cause. We present the case of a 45-year-old female patient with complaints of recurrent abdominal pain, bloating, and joint swelling. Laboratory testing showed decreased C1q and C4 complement levels, and C1 esterase inhibitor levels, indicative of AAE-C1INH. Further work up confirmed a diagnosis of extranodal marginal zone lymphoma with involvement of the bone marrow and spleen. Treatment with rituximab led to resolution of angioedema symptoms and almost complete remission of underlying lymphoma. This case underscores the importance of evaluating an underlying lymphoproliferative disorder in AAE-C1INH. Therefore, the early participation of a multidisciplinary team including specialists in immunology, hematology, and oncology is necessary for appropriate management.