Shingles Flashcards
What is shingles?
The reactivation of varicella zoster virus that lies dormant in nerve ganglia following chickenpox
What is the prodromal phase of shingles?
Burning pain over the affected dermatome for 2-3 days
Fever
Lethargy
Headache
What is the appearance of the rash in shingles?
Initially erythematous and macular, but becomes papular and then vesicular
Demarcated by the dermatome
Does not cross the midline
What is herpes zoster ophthalmicus?
Viral infection of the nerve that supplies sensation to the eye surface and eyelids
Where does the rash occur in herpes zoster ophthalmicus?
Over the trigeminal divison of the ophthalmic nerve
What are the symptoms of herpes zoster ophthalmicus?
Painful red eye
Fever
Malaise
Headache
Erythematous vesicular rash
What is the management of shingles?
Oral acyclovir if presented within 72 hoursW
When should a patient be given IV antivirals for shingles?
Immunocompromised
Ophthalmic symptoms
Suspiscion of encephalitis/meningitis/myelitis
What is the first line pain management for shingles?
NSAIDs/paracetamol
What is the second line pain management for shingles?
Neuropathic agents - amitripyline
What are the complications of shingles?
Secondary bacterial infection of skin lesions
Corneal ulcers - scarring and blindness
Post herpatic neuralgia
- Neuropathic pain at the site of shingles infection
What are the risk factors for shingles?
Increasing age
HIV
Immunosuppresive conditions
