Viral Infections Haase

Question 1

Definition/Epidemiology of Herpes Zoster

Answer 1

aka “shingles”, reactivation of Varicella Zoster infection (chicken pox). 1/3 individuals will have herpes zoster in lifetime. Most cases are older, >60yrs

Question 2

risk factors of herpes zoster

Answer 2

1. increasing age
2. immunocompromised (inc risk and severity)
3. family history of infection

Question 3

pathogenesis of herpes zoster

Answer 3

dermatomal distribution, one sided on body, rash is common

1. after primary infection, virus is dormant in spinal ganglion cells
2. reactivation when cell mediated immunity declines
3. reactivated by stressors
4. virus travels along peripheral nerves - trigeminal nerves and thoracic ganglia

Question 4

prodrome

Answer 4

1. continual burning/tingling, loss of sensation or sharp/deep boring pain
2. headache, malaise, photophobia, fever
3. few hrs to days before rash

Question 5

acute

Answer 5

1. pain along dermatomes (mild itch to severe pain)
2. most common at: chest, abdomen, neck,eye
3. clear vesicles within 5 days
4. unilateral rash
5. pustular/crusty legions with 14 days

Question 6

Postherpetic neuralgia (PHN)

Answer 6

infection gones, but damage has been done to nerves

1. pain >120 days after onset of rash or cutaneous healing
2. stabbing, burning, aching, electrical like pain
3. incidence and duration are directly correlated to patient’s age
4. affected areas sensitive to hot/cold

Question 7

who to treat, recommended in

Answer 7

a. age >50
b. severe cases
c. immunocompromised

Question 8

most severe cases include

Answer 8

mod-severe pain, severe rash, involvement of face or eye, complications present

Question 9

treatment goals

Answer 9

limit extent of infection

1. accelerate resolution
2. limit severity and duration of pain
3. red risk of complcations

Question 10

treatment of acute infection of herpes zoster

Answer 10

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