{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:14Z","timestamp":1787016974002,"version":"build-2736575974"},"reference-count":15,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,3,29]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>This case report describes an 84-year-old man who presented with 3 weeks of gradually worsening right arm weakness associated with a painful vesicular rash across his arm. This occurred 3\u2009days after his first dose of the ChAdOx1 nCoV-19\/AZD1222 (University of Oxford, AstraZeneca and the Serum Institute of India) vaccine. The diagnosis was complicated by the presence of right C5\u2013C6 foraminal stenosis compressing on the C6 nerve root sheath on non-contrast MRI, leading to an initial diagnosis of cervical radiculopathy. However, a positive varicella zoster virus-PCR test and findings of abnormal contrast enhancement of his right C5\u2013C7 nerve roots on gadolinium-enhanced MRI resulted in a revision of his diagnosis to zoster radiculopathy. He was subsequently commenced on oral valacilovir and made significant recovery. This report aims to highlight the diagnostic dilemma between cervical radiculopathy secondary to spondylosis and zoster radiculopathy and how an erroneous diagnosis could result in inappropriate, aggressive surgical intervention and delayed treatment with antiviral therapy.<\/jats:p>","DOI":"10.1136\/bcr-2022-248943","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T11:28:01Z","timestamp":1653305281000},"page":"e248943","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Acute herpes zoster radiculopathy mimicking cervical radiculopathy after ChAdOx1 nCoV-19\/AZD1222 vaccination"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0172-7872","authenticated-orcid":false,"given":"Andrew","family":"Dermawan","sequence":"first","affiliation":[{"name":"General Medicine, Royal Perth Hospital, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2505-9423","authenticated-orcid":false,"given":"Matthew Jun Min","family":"Ting","sequence":"additional","affiliation":[{"name":"Geriatric department, St John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3327-6076","authenticated-orcid":false,"given":"Thomas","family":"Chemmanam","sequence":"additional","affiliation":[{"name":"Neurology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"},{"name":"Neurology, St John of God Midland Public and Private Hospital, Midland, Australian Capital Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chok","family":"Lui","sequence":"additional","affiliation":[{"name":"Geriatric department, St John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,22]]},"reference":[{"key":"2025082711032336000_15.4.e248943.1","unstructured":"Hsu P . Acute lumbosacral radiculopathy: Pathophysiology, clinical features, and diagnosis - UpToDate. Available: https:\/\/www-uptodate-com.qelibresources.health.wa.gov.au\/contents\/acute-lumbosacral-radiculopathy-pathophysiology-clinical-features-and-diagnosis?search=zoster radiculopathy&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3 [Accessed 20 Jul 2021]."},{"key":"2025082711032336000_15.4.e248943.2","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.mayocpiqo.2020.06.001","article-title":"Acute herpes zoster radiculopathy of the lower extremity with dermatomal rash and lumbar nerve enhancement on MRI","volume":"4","author":"Bhushan","year":"2020","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"2025082711032336000_15.4.e248943.3","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199711)20:11<1433::AID-MUS11>3.0.CO;2-2"},{"key":"2025082711032336000_15.4.e248943.4","doi-asserted-by":"crossref","DOI":"10.1186\/s13104-015-1272-z","article-title":"Herpes zoster sciatica mimicking lumbar canal stenosis: a case report","volume":"8","author":"Koda","year":"2015","journal-title":"BMC Res Notes"},{"key":"2025082711032336000_15.4.e248943.5","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(91)90124-G"},{"key":"2025082711032336000_15.4.e248943.6","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jcm.2019.03.003","article-title":"Cervical radiculopathy associated with shingles herpes zoster infection","volume":"18","author":"Miller","year":"2019","journal-title":"J Chiropr Med"},{"key":"2025082711032336000_15.4.e248943.7","doi-asserted-by":"publisher","DOI":"10.1177\/0300060513478084"},{"key":"2025082711032336000_15.4.e248943.8","doi-asserted-by":"crossref","first-page":"5231","DOI":"10.1002\/jmv.27036","article-title":"Herpes zoster emergence following mRNA COVID-19 vaccine","volume":"93","author":"Eid","year":"2021","journal-title":"J Med Virol"},{"key":"2025082711032336000_15.4.e248943.9","doi-asserted-by":"crossref","unstructured":"Arora P , Sardana K , Mathachan SR . Herpes zoster after inactivated COVID-19 vaccine: a cutaneous adverse effect of the vaccine. J Cosmet Dermatol 2021.","DOI":"10.1111\/jocd.14268"},{"key":"2025082711032336000_15.4.e248943.10","doi-asserted-by":"crossref","DOI":"10.7774\/cevr.2021.10.2.198","article-title":"A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?","volume":"10","author":"Aksu","year":"2021","journal-title":"Clin Exp Vaccine Res"},{"key":"2025082711032336000_15.4.e248943.11","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1111\/jocd.14035","article-title":"Herpes zoster following inactivated COVID-19 vaccine: a coexistence or coincidence?","volume":"20","author":"Bostan","year":"2021","journal-title":"J Cosmet Dermatol"},{"key":"2025082711032336000_15.4.e248943.12","first-page":"1","article-title":"Varicella-Zoster-Mediated radiculitis reactivation following cervical spine surgery: case report and review of the literature","volume":"2013","author":"Drazin","year":"2013","journal-title":"Case Rep Infect Dis"},{"key":"2025082711032336000_15.4.e248943.13","unstructured":"Albrecht M . Treatment of herpes zoster in the immunocompetent host. UpToDate, 2020. Available: https:\/\/www-uptodate-com.qelibresources.health.wa.gov.au\/contents\/treatment-of-herpes-zoster-in-the-immunocompetent-host?search=zoster treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 [Accessed 17 Mar 2022]."},{"key":"2025082711032336000_15.4.e248943.14","unstructured":"RH D , RW J JB , et al . Recommendations for the management of herpes zoster. Clin Infect Dis 2007;44."},{"key":"2025082711032336000_15.4.e248943.15","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13957"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-248943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:03:32Z","timestamp":1756317812000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-248943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,22]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bcr-2022-248943"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-248943","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}