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Shingles (Pathophysiology (Herpes zoster virus remains dormant in the…
Shingles
Pathophysiology
Herpes zoster virus remains dormant in the dorsal root ganglia and/or cranial nerve ganglia
Reactivation causes shingles
Primary infection is transmitted by respiratory droplets
Invades respiratory mucosa and replicates in lymph nodes
Occurs after previous primary infection with chickenpox
Disseminates via mononuclear cells to infect epithelial cells
Signs
Pain and tingling
Most commonly in lower thoracic dermatomes and ophthalmic division of trigeminal nerve
Rash: papules in dermatomal distribution
Investigations
Viral PCR
Culture
Clinical diagnosis
Treatment
IV aciclivor if pregnant, immunosuppressed or severe disease
Oral aciclovir
Vaccination is only given >70 to prevent shingles reactivation
Complications
Ramsay Hunt syndrome
Person is infectious until scabs form
Post herpetic neuralgia - pain in distribution of nerves affected
Definition
Shingles = Infection of human herpes virus 3/varicella zoster virus