A 59-year-old man developed right-sided abdominal pain, hyperesthesias, dysesthesias, anorexia and nausea. The pain localized to the right lower quadrant and the patient was worked up for appendicitis. Labs and CT scan were normal. He was observed overnight. The following morning a skin eruption along the right T11 dermatome appeared. A diagnosis of herpes zoster was made and the patient was placed on antiviral medication for 7 days. After several days of headache, fatigue, myalgia, the viremia symptoms resolved. The image shows the lesions at their peak on day 5. Herpes zoster can mimic the signs and symptoms of appendicitis, and while uncommon, should be included as a low probability differential diagnostic possibility.
Contributing Surgeon: David Welling -->
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