Herpes Zoster - Causes, Symptoms and Treatment

Herpes Zoster Definition

The culprit is the varicella-zoster virus. Primary infection with this virus causes chickenpox (varicella). At this time the virus infects nerves (namely, the dorsal root ganglia) where it remains latent (lies low) for years. It may be reactivated to cause shingles with blisters over the distribution of the affected nerve accompanied by often intense pain and itching.

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 also called shingles, zona, and zoster.

Herpes Zoster Causes

Herpes zoster is an acute, localized infection, which causes a painful, blistering rash. Herpes zoster, or shingles, is caused by the same virus that causes chickenpox . After an episode of chickenpox, the virus becomes dormant in the body. Herpes zoster occurs as a result of the virus re-emerging after many years. Herpes zoster may be contagious through direct contact to an individual who has not had chickenpox, and therefore has no immunity. Herpes zoster may affect any age group, but it is much more common in adults over 60 years old, in children who had chickenpox before the age of one year, and in individuals whose immune system is weakened.

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. The cause of the reactivation is usually unknown, but seems to be linked to aging, stress or an impaired immune system. Often only one attack occurs, without recurrence.

Herpes Zoster Symptoms

Herpes zoster usually runs a typical course with classic signs and symptoms. Serious complications sometimes occur. Herpes zoster begins with fever.

The other symptoms of the herpes zoster may be included:

• Fever
• Chills
• Headache
• Hearing loss
• Joint pain
• Genital lesions
• Abdominal pain
• Drooping eyelid
• Lymph node swelling
• Vision abnormalities
• Taste abnormalities
• Loss of eye motion
• General feeling of malaise

Herpes Zoster Treatment

No specific treatment exists except for symptomatic relief, such as pain medication. The primary goal of supportive treatment is to relieve itching and neuralgic pain with calamine lotion.

Acyclovir and famciclovir shorten the duration of pain and symptoms in normal adults.

If bacteria have infected ruptured vesicles, treatment usually includes an appropriate systemic antibiotic. Trigeminal zoster with corneal involvement calls for instillation of idoxuridine ointment or another antiviral agent.

Corticosteroids, such as prednisone, may occasionally be used to reduce inflammation and risk of post-herpetic neuralgia. They have been shown to be most effective in the elderly population. Corticosteroids have certain risks that should be considered before using them.