oral med Flashcards
- VZV causes two different diseases
chicken pox and herpes zoster”shingles”
what is the primary infection of vzv
chicken pox
where does vzv stay latent in?
spinal cord ganglia and cranial nerves
how reactivation occurs?
predisposing factors trigger the latent virus so it spreads from ganglion to specific dermatome
manifestations of chicken pox
vesicular rash
ulcers
fever
oral painless lesions(lips and palate)
ttt of chicken pox
self limiting*****
varivax vaccine
secondary infection o vsv
shingles
predisposing factors of vzv causing shingles as a reactivation
trauma to spinal cord
malignancy
immunodeficiency
old age(>45yrs)
immunocompromised
specific prodrome of shingles
unilateral tenderness along the involved nerve(ophthalmic/maxillary/mandibular)
specific signs of shingles
unilateral severe itching and severe burning pain
dermatomal rash
ulcers that leave crust when ruptured and scarring occurs
what causes trigeminal shingles
occurs when reactivation uccurs within trigeminal ganglion
vesicles of trigeminal shingles are?
neuralgic extreme pain
unilateral
dermatomic distribution
rupture leaving ulcers tha scars
reactivation of vzv affecting facial nerve via geniculate ganglion
ramsay hunt syndrome
which ganglion is the normal shingles?
spinal cord ganglion
hamsay hunt ganglion name?
geniculate ganglion
specific prodrome to ramsay hunt
pain localized to ear or radiating to jaw and neck
ramsay hunt main signs
herpetic oticus
facial palsy
ant 2/3 of tongue affected
unilateral localized pain followed by vesicles then ulcers
most common complication of shingles
post herpetic neuralgia
signs of post herpetic neuralgia
Pain or dysesthesia persisting for 3 or more months after rash resolves.
* Pain is due to inflammation and fibrosis of the affected nerve.
* Localized, acute episodic and sharp pain.
ttt of neuralgia
gabapentin
capsaicin cream 0.075
lidocaine patch
if pt with scars and then get neuralgic pain expect what?
ppst herpetic neuralgia after shingles
ttt of shingles
acyclovoir 800mg 5 times for 10 days
