Frequency of Putative Enteric Zoster Diagnosed Using Saliva Samples in Patients With Abdominal Pain: a Prospective Study
Frequency of Putative Enteric Zoster Diagnosed Using Saliva Samples in Patients With Abdominal Pain: a Prospective Study
The aim of this study is to identify the frequency of enteric zoster using salivary varicella
 zoster virus (VZV) DNA PCR in patients who visit the emergency room due to acute abdominal
 pain.
Varicella zoster virus (VZV) infects and establishes latency in neurons in the ganglia of the
 cranial nerve, dorsal root, and enteric ganglia. VZV reactivation in enteric neurons (enteric
 zoster) can cause nonspecific abdominal pain and/or serious gastrointestinal dysfunction
 without cutaneous manifestations. Detection of VZV DNA in saliva may be useful for
 identifying enteric zoster. We evaluated the frequency of putative enteric zoster based on
 the presence of salivary VZV DNA in patients with acute abdominal pain.

 Adult patients who visited the emergency room due to moderate to severe acute abdominal pain
 were prospectively enrolled at a tertiary hospital between May 2019 and November 2019.
 Abdominopelvic computed tomography (APCT) was performed in all patients. Saliva samples were
 collected from all studied patients. Enteric zoster was suspected based on the presence of
 salivary VZV DNA, detected using real-time polymerase chain reaction (PCR).
Inclusion Criteria:

 -  Patients aged ≥ 18, and < 80 years

 -  ER-visited patients with acute abdominal pain

 -  Numerical rating scale (NRS) score ≥ 4

 -  Unresponsive to gastrointestinal motility drug, antacid

 Exclusion Criteria:

 -  Unwilling or unable to give informed consent forms

 -  Patients taking antiviral agents

 -  Patients complaining mild abdominal pain (NRS score ≤ 3)