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Thursday, May 11, 2017

Introduction to Herpes zoster



Introduction
Also called shingles, herpes zoster is an acute unilateral and segmental inflammation of the dorsal root ganglia caused by infection with the herpesvirus varicella-zoster, which also causes chickenpox. 

This infection usually occurs in adults. It produces localized vesicular skin lesions confined to a dermatome and severe neuralgic pain in peripheral areas innervated by the nerves arising in the inflamed root ganglia.
The prognosis is good unless the infection spreads to the brain. Eventually, most patients recover completely, except for possible scarring and, in corneal damage, visual impairment. Occasionally, neuralgia may persist for months or years.
Herpes zoster is found primarily in adults, especially those older than age 50. It seldom recurs.

Pathophysiology
Herpes zoster results from reactivation of varicella virus that has lain dormant in the cerebral ganglia (extramedullary ganglia of the cranial nerves) or the ganglia of posterior nerve roots since a previous episode of chickenpox.
Exactly how or why this reactivation occurs isn’t clear. Some believe that the virus multiplies as it’s reactivated and that it’s neutralized by antibodies remaining from the initial infection. However, if effective antibodies aren’t present, the virus continues to multiply in the ganglia, destroy the host neuron, and spread down the sensory nerves to the skin.

Clinical features
Herpes zoster usually runs a typical course with classic signs and symptoms. Serious complications sometimes occur.
Onset of disease
Herpes zoster begins with fever and malaise. Within 2 to 4 days, severe deep pain, pruritus, and paresthesia or hyperesthesia develop, usually on the trunk and occasionally on the arms and legs in a dermatomal distribution. Pain may be continuous or intermittent and usually lasts from 1 to 4 weeks.

Skin lesions
Up to 2 weeks after the first symptoms, small, red, nodular skin lesions erupt on the painful areas. These lesions commonly spread unilaterally around the thorax or vertically over the arms or legs. Sometimes nodules don’t appear, but when they do, they quickly become vesicles filled with clear fluid or pus.
About 10 days after they appear, the vesicles dry and form scabs. (See Skin lesions in herpes zoster.) When they rupture, such lesions commonly become infected and, in severe cases, may lead to the enlargement of regional lymph nodes; they may even become gangrenous. Intense pain may occur before the rash appears and after the scabs form.

Cranial nerve involvement
Occasionally, herpes zoster involves the cranial nerves, especially the trigeminal and geniculate ganglia or the oculomotor nerve. Geniculate zoster may cause vesicle formation in the external auditory canal, ipsilateral facial palsy, hearing loss, dizziness, and loss of taste.
Trigeminal ganglion involvement causes eye pain and, possibly, corneal and scleral damage and impaired vision. Rarely, oculomotor involvement causes conjunctivitis, extraocular weakness, ptosis, and paralytic mydriasis.

Rare complications

In rare cases, herpes zoster leads to generalized central nervous system infection, muscle atrophy, motor paralysis (usually transient), acute transverse myelitis, and ascending myelitis. More commonly, generalized infection causes acute retention of urine and unilateral paralysis of the diaphragm. In postherpetic neuralgia, a complication most common in elderly patients, intractable neuralgic pain may persist for years. Scars may be permanent.

Diagnosis
A positive diagnosis of herpes zoster usually isn’t possible until the characteristic skin lesions develop. Before then, the pain may mimic that of appendicitis, pleurisy, or other conditions. Diagnostic test results include the following:
  • Examination of vesicular fluid and infected tissue shows eosinophilic intranuclear inclusions and varicella virus.
  • Lumbar puncture shows increased cerebrospinal fluid (CSF) pressure; examination of CSF shows increased protein levels and, possibly, pleocytosis.
  • Staining antibodies from vesicular fluid and identification under fluorescent light differentiate herpes zoster from localized herpes simplex.
Treatment
  • No specific treatment exists. 
  • The primary goal of supportive treatment is to relieve itching and neuralgic pain with calamine lotion or another antipruritic; aspirin, possibly with codeine or another analgesic; and, occasionally, collodion or compound benzoin tincture applied to unbroken lesions.
  • If bacteria have infected ruptured vesicles, treatment usually includes an appropriate systemic antibiotic.
  • Trigeminal zoster with corneal involvement necessitates instillation of idoxuridine ointment or another antiviral agent.
  • To help a patient cope with the intractable pain of postherpetic neuralgia, administer a systemic corticosteroid, such as cortisone or, possibly, corticotropin, to reduce inflammation as well as tranquilizers, sedatives, or tricyclic antidepressants with phenothiazines.
  • Acyclovir seems to stop progression of the rash and prevent visceral complications. 
  • In immunocompromised patients—both children and adults—acyclovir therapy may be administered I.V. The drug appears to prevent disseminated, life-threatening disease in some patients.

9 comments:

  1. I was diagnosed with herpes since I was a child. My mother has them too, and does nothing to stop the spread. it was hard to not kiss my children all the time, but they grow up knowing that “when mommy has a lip owie, she can’t kiss.” They give me kisses on my forehead instead and we have extra hugs. It was also very painful to not kiss my partner. However, I was 100% determined to not pass this on to anyone, especially those I love.I mostly want to thank those who feel the way I do.
    dr saibu health herbs home helped me and my family to find happiness and peace ,their herbal remedies for herpes works like miracle,i was totally cured of herpes virus within 5 weeks of usage . for your herpes cure contact them today
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    ReplyDelete
    Replies

    1. I’m here to testify about what Dr Okosun did for me. I have been suffering from (GENITAL HERPES VIRUS) disease for the past 4 years and had constant pain and inching, especially in my private part. During the first year, I had faith in God that i would be cured someday.This disease started circulating all over my body and I have been taking treatment from my doctor, few weeks ago I came across a testimony of Rose Smith on the internet testifying about a Man called Dr Okosun on how he cured her from 7 years HSV 2. And she also gave the email address of this man, advise anybody to contact him for help on any kind of diseases that he would be of help, so I emailed him telling him about my (HSV 2) he told me not to worry that I was going to be cured!! Well, I never doubted him I have faith he can cure me too,, Dr Okosun prepared and sent me Healing Oil, Soap, roots and herbs which I took. In the first one week, I started experiencing changes all over me, after four weeks of using his Roots/ Herbs, Oil and Soap, I was totally cured. no more inching , pain on me anymore as Dr Okosun assured me. After some time I went to my doctor to do another test behold the result came out negative. So friends my advise is if you have such disease or know anyone who suffers from it or any other disease like HPV, HBV, HIV, ALS, HBP, CANCER etc. you can contact Dr.Okosun for help via drokosun55@gmail or whatsapp +2348124363791

      Delete
  2. Dr ogden herbal medicine is a good remedy for herpes simplex virus cure. My name is Theophiles Kum ,I just want to share this article about Dr ogden who helped me, i want to inform the public how i was cured from (HERPES SIMPLEX VIRUS) by Dr ogden, i visited different hospital but they gave list of drugs like Familiar , Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Dr ogden cured them, when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, am a free person now without any problem, my HERPES result came out negative, I pray to God to never let me and my family forget you in our life,i am now cured permanently.you can also get your self cured, if you really need this dr's help,you can reach him now email:(drogdentestimony@gmail.com) or via WhatsApp+2348117963221
    This is real,
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    ReplyDelete
    Replies
    1. I’m here to testify about what Dr favour did for me. I have been suffering from (GENITAL HERPES VIRUS) disease for the past 4 years and had constant pain and inching, especially in my private part. During the first year, I had faith in God that i would be cured someday.This disease started circulating all over my body and I have been taking treatment from my doctor, few weeks ago I came across a testimony of Rose Smith on the internet testifying about a Man called Dr Favour on how he cured her from 7 years HSV 2. And she also gave the email address of this man, advise anybody to contact him for help on any kind of diseases that he would be of help, so I emailed him telling him about my (HSV 2) he told me not to worry that I was going to be cured!! Well, I never doubted him I have faith he can cure me too,, Dr Favour prepared and sent me Healing Oil, Soap, roots and herbs which I took. In the first one week, I started experiencing changes all over me, after four weeks of using his Roots/ Herbs, Oil and Soap, I was totally cured. no more inching , pain on me anymore as Dr Favour assured me. After some time I went to my doctor to do another test behold the result came out negative. So friends my advise is if you have such disease or know anyone who suffers from it or any other disease like HPV, HBV, HIV, ALS, HBP, CANCER etc. you can contact Dr.favour for help via drfavour37@gmail.com or whatsapp +2348028081669

      Delete

  3. I’m here to testify about what Dr Okosun did for me. I have been suffering from (GENITAL HERPES VIRUS) disease for the past 4 years and had constant pain and inching, especially in my private part. During the first year, I had faith in God that i would be cured someday.This disease started circulating all over my body and I have been taking treatment from my doctor, few weeks ago I came across a testimony of Rose Smith on the internet testifying about a Man called Dr Okosun on how he cured her from 7 years HSV 2. And she also gave the email address of this man, advise anybody to contact him for help on any kind of diseases that he would be of help, so I emailed him telling him about my (HSV 2) he told me not to worry that I was going to be cured!! Well, I never doubted him I have faith he can cure me too,, Dr Okosun prepared and sent me Healing Oil, Soap, roots and herbs which I took. In the first one week, I started experiencing changes all over me, after four weeks of using his Roots/ Herbs, Oil and Soap, I was totally cured. no more inching , pain on me anymore as Dr Okosun assured me. After some time I went to my doctor to do another test behold the result came out negative. So friends my advise is if you have such disease or know anyone who suffers from it or any other disease like HPV, HBV, HIV, ALS, HBP, CANCER etc. you can contact Dr.Okosun for help via drokosun55@gmail or whatsapp +2348124363791

    ReplyDelete
  4. Hi it's laa! 9 months ago my doctor told me I was diagnosed with HSV2. I was heart broken, However that same month i found a Dr. who helped me to cured the virus with natural herbal treatment permanently. thanks to Dr. omohan for his natural herbal treatment that eliminated this virus out in my body forever. his contact information for any incurable virus via; dromohanherbalmedicine@gmail.com or whatsapp him or call him through his phone number +2348164816038.    

    ReplyDelete
  5. Herpes adalah penyakit serius dan berulang yang tidak dapat disembuhkan melalui obat-obatan atau suntikan oleh dokter Amerika tetapi cara terbaik untuk menangani Herpes adalah dengan meminum obat herbal alami untuk itu, saya telah membaca tentang DR JAMES, dokter ahli herbal yang menyembuhkan saya dari herpes dengan obat herbal yang kuat. Saya menghubungi dia untuk mengetahui bagaimana dia dapat membantu saya dan dia mengatakan kepada saya untuk tidak pernah khawatir
    bahwa dia akan membantu saya dengan ramuan alami dari Tuhan!
    Setelah 2 hari menghubunginya, dia memberi tahu saya bahwa obatnya sudah siap dan
    dia mengirimkannya kepada saya melalui UPS SPEED POST dan itu sampai kepada saya setelah 3 hari!
    Saya menggunakan obat itu seperti yang dia perintahkan kepada saya (PAGI dan MALAM) dan ternyata saya
    sembuh!
    ini benar-benar seperti mimpi tetapi saya sangat senang! untuk orang yang menderita penyakit berikut: Penyakit Alzheimer, Penyakit Bechet, Penyakit Crohn, Penyakit Parkinson, Skizofrenia, Kanker Paru-Paru, Kanker Payudara, Kanker Colo-Rektal, Kanker Darah, Kanker Prostat, siva. Faktor Insomnia Keluarga Terakhir V Mutasi, Epilepsi Penyakit Dupuytren, Tumor bulat-sel kecil Desmoplastik Diabetes, penyakit Celiac, Penyakit Creutzfeldt-Jakob, Angiopati Amiloid Serebral, Ataksia, Artritis, Amyotrophic Lateral Sclerosis, Fibromyalgia, Fluoroquinolone Toksisitas
    Syndrome Fibrodysplasia Ossificans ProgresS sclerosis, Kejang, penyakit Alzheimer, Adrenocortical carcinoma. Asma, Penyakit alergi. AIDS, Herpe, Copd, Glaucoma.
    Dementia.Lupus.
    , Penyakit Cushing, Gagal Jantung, Multiple Sclerosis, Hipertensi, Kanker Colo_Rectal, Penyakit Lyme, Kanker Darah, Kanker Otak, Kanker Payudara, Kanker Paru-Paru, Kanker Ginjal, HIV, Herpes, Hepatitis B, Radang Hati, Diabetes, Fibroid,
    harus menghubungi dia untuk obat herbal karena saya adalah kesaksian hidup dan saya sembuh dari herpes dan obatnya sah. Saya mengiriminya apa yang dia minta dan dia mengirimi saya obatnya yang saya minum selama 2 minggu yang baik dan hari ini saya di sini dengan hasil negatif. Ketika saya pergi untuk tes saya sangat senang setelah minum obat herbal, saya memberi penghormatan kepada negaranya untuk merayakan bersamanya di festival Afrika-nya yang dia katakan biasanya terjadi setiap tahun. Anda dapat menghubunginya melalui VIA E-mail drjamesherbalmix@gmail.com atau nomor whatsapp: +2348152855846

    ReplyDelete
  6. I am writing this comment with tears of joy a months ago i found out i was diagnosed with Herpes. I was heart broken, However that same month i was recommended to a Dr. who helped me to cured the virus with natural herbal treatment now i fully believed on natural treatment iam so happy thanks to Dr. Odion . contact information: drodionherbalhome12@gmail.com or massage him on WhatsApp +234 9019421176 and He also have herbs medicine to cured the following diseases; eczema,urethra wart,chronic problems.Herpes, Cancer, Als,Hepatitis, Diabetes, HPV,Infections,ulcer, asthma, COPD. ETC

    ReplyDelete
  7. I'm recommending Dr Aza to everyone who have herpes simplex virus to get the cure from him. I was diagnose of genital herpes in 2019 and i have been searching and asking questions to see if i could get something to cure the disease because i did not believe what the doctors say that no cure is found yet. I came across a comment on Youtube and the person testify how she was cured from herpes and hpv after using Dr Aza herbal medicine. I quickly contact Dr Aza and explain my problem to him and he prepare the herbs and send it to me through UPS and gave me instructions on how to use it and tell me to go for checkup after usage which i did after two weeks of taken the herbal medicine and my result was NEGATIVE. I waited another month and retested the result was still NEGATIVE and my doctor told me that am completely free from herpes. Am so happy and grateful to Dr Aza for what he has done for me and i will continue to share this for people out there to know that there is cure for herpes. You can contact Dr Aza on email and WhatsApp to get the cure from him. Email:drazaherbalcenter@gmail.com and WhatsApp +1(315) 795 1518 or visite his website at www.drazaherbalcenter.com  ...                                                                 

    ReplyDelete