Description of Event or Problem · 1
A HEALTH CARE PROFESSIONAL REPORTED THAT A PT UNDERWENT AN INJECTION OF TWO 1CC SYRINGS OF RESTYLANE TO THEIR NASOLABIAL FOLDS AND VERMILION BORDER IN 2005. THE INJECTIONS WERE PERFORMED IN THE HOSP IMMEDIATELY AFTER THE PT HAD UNDERGONE A BROW LIFT AND A CHIN AUGMENTATION. THE PT WAS PLACED UNDER GENERAL ANESTHESIA WITH DIPRIVAN AND AS AN ADJUNCT LATER RECEIVED A 2 PERCENT LIDOCAINE DENTAL BLOCK PRIOR TO THE RESTYLANE INJECTIONS. IN 2005 THE PT CONTACTED THE PHYSICIAN'S OFFICE TO REPORT A BURNING SENSATION AND PAIN WITH PALPATION IN THE AREA THEIR RIGHT NASOLABIAL FOLD ANDTHE RIGHT SIDE OF THEIR NOSE. TWO DAYS LATER THE PHYSICIAN ASSESSED THE PT AT HIS OFFICE. THE PAIN AND BURNING SENSATIONS HAD WORSENED AND THE AREA WAS MILDLY SWOLLEN, ERYTHEMATOUS, AND SMALL PUSTULES WERE PRESENT ON THE RIGHT SIDE OF THEIR NOSE. ALSO PRESENT WAS A SMALL ULCERATION OF THE INTERNAL ORAL MUCOSA, WHICH CONCERNED THE PHYSICIAN. THEIR INITIAL ASSESSMENT OF THE ORAL MUCOSAL ULCER WAS THAT IT WAS A CASE OF NECROSIS. HE LATER CONSULTED WITH ANOTHER PHYSICIAN AND UPON FURTHER CONSIDERATION OF THE SYMPTOMS THAT INCLUDED THE PRESENCE OF BLANCHING AT THE SITE OF THE ULCERATION, PULSES ON THE NOSE,AND THE EXTREME PAIN PRESENT THROUGHOUT THE AFFECTED AREA HAD CHANGED THE DIAGNOSIS TO HERPES ZOSTOR. THE NEXT DAY HAS PRESCRIBED THE MEDICATIONS MODROL DOSEPAK, VALTREX (500 MG BID), AND NEURONTIN (300 MG TID) AND REPORTS THAT AS TWO DAYS LATER THE PT APPEARS TO BE RESPONDING TO TREATMENT. HE CONFIRMED THE PT HAS NO HISTORY OF HERPES ZOSTER.