{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:10:07Z","timestamp":1756372207089,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,7,8]]},"abstract":"<jats:p>Patients with inflammatory bowel disease (IBD), particularly those on immunosuppressive medications, suffer a high incidence of, and worse clinical outcomes relating to, herpes zoster (HZ) reactivation. We report on the presentation and management of a patient with Crohn's disease who developed severe perianal HZ after starting azathioprine and oral budesonide treatment. The zoster vaccine may prevent such zoster reactivation in patients with IBD. The zoster vaccine is effective in decreasing the risk of HZ in older adults but its role in younger adults and those with IBD has not been tested prospectively. A review of the potential risks and benefits of this live vaccine in patients with IBD and an approach to further determining its role in this patient population is discussed.<\/jats:p>","DOI":"10.1136\/bcr-2016-216527","type":"journal-article","created":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T10:54:00Z","timestamp":1469012040000},"page":"bcr2016216527","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Severe perianal shingles during azathioprine and budesonide treatment for Crohn's disease\u2014preventable with zoster vaccine?"],"prefix":"10.1136","volume":"2016","author":[{"given":"Timothy Ross","family":"Elliott","sequence":"first","affiliation":[{"name":"University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Department of Colorectal Medicine and Genetics, Melbourne Health, Parkville, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Miller","sequence":"additional","affiliation":[{"name":"University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Finlay A","family":"Macrae","sequence":"additional","affiliation":[{"name":"Department of Colorectal Medicine and Genetics, Melbourne Health, Parkville, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,7,20]]},"reference":[{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2013.12.013"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.2","first-page":"1","article-title":"Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"57","author":"Harpaz","year":"2008","journal-title":"MMWR Recomm Rep"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.3","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.22950"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.4","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12182"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051016"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.6","first-page":"1","article-title":"Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"56","author":"Marin","year":"2007","journal-title":"MMWR Recomm Rep"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.01.036"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.8","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq077"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.9","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1038\/ajg.2013.378","article-title":"Varicella zoster exposure in patients with inflammatory bowel disease\u2014recall is not enough","volume":"109","author":"Aggarwal","year":"2014","journal-title":"Am J Gastroenterol"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2012.05150.x"},{"key":"2025082801571964000_2016.jul20_1.bcr2016216527.11","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1001\/jama.2012.7304","article-title":"Association between vaccination for herpes zoster and risk of herpes zoster infection among older patients with selected immune-mediated diseases","volume":"308","author":"Zhang","year":"2012","journal-title":"JAMA"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-216527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:57:30Z","timestamp":1756371450000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-216527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,20]]},"references-count":11,"alternative-id":["10.1136\/bcr-2016-216527"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-216527","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2016,7,20]]}}}