HERPES ZOSTER

Also known as Shingles/Acute Posterior Ganglionitis

DEFINITION
Commonly known as Shingles.
Is cause by the same virus responsible for chickenpox, the
varicella-zoster virus.
This type of viral infection is characterized by a red skin rash
that can cause pain and burning.
usually appears as a stripe of blisters on one side of the
body, typically on the torso, neck, or face.
Most cases clear up within two to three weeks.
RISK FACTORS
Can occur in anyone who has had chickenpox.
being 60 or older
having diseases that weaken the immune system, such as
HIV, AIDS, or cancer
having had chemotherapy or radiation treatment
taking drugs that weaken the immune system
SIGNS AND SYMPTOMS
Pain
Burning
Rash

Rash characteristics include:

red patches
fluid-filled blisters that break easily
a rash that wraps around from the spine to the torso
a rash on the face and ears
Itching
Some people experience symptoms beyond pain and
rash with shingles. These symptoms may include:
a fever
chills
a headache
fatigue
muscle weakness

Rare and serious complications of shingles include:

pain or rash that involves the eye, which should be treated in
order to avoid permanent eye damage
loss of hearing or intense pain in one ear, dizziness, or loss of
taste on your tongue, which can be symptoms of Ramsay Hunt
syndrome
bacterial infections, which you may have if your skin becomes
red, swollen, and warm to the touch
INCUBATION PERIOD
Incubation period of herpes zoster is unknown, but is believed
to be 13 to 17 days.

PERIOD OF COMMUNICABILITY
Is communicable day before the appearance of the 1st rash
until five to six days after the last crust disappears.
MODE OF TRANSMISSION
Through direct contact, specially through droplet
infection and airborne spread.
It can also be transmitted through indirect contact.
CLINICAL MANIFESTATION
The erythematous base of the skin lesion appears.
Pain of varying intensity is a presenting symptoms in about
two-thirds of patient.
Fever, malaise, anorexia, and headache occur for one or
more days.
Regional lymph nodes are involve in the early stage of the
disease.
Gasserian ganglionitis
Ramsay-Hunt Syndrome
DIAGNOSTIC EXAM
The characteristic skin rash may be diagnostic.
Tissue culture technique
Smear of vesicle fluid
Microscopy
COMPLICATIONS
Encephalitis
Paralytic ileus, bladder paralysis
Ophthalmic herpes, which may lead to blindness
MODALITIES OF TREATMENT
Symptomatic
Antiviral drugs
Analgesic to control the pain
Anti-inflammatory
NURSING MANAGEMENT
Keep the patient comfortable.
Keep the patient in strict isolation.
Apply cool, wet dressing with NSS to pruritic lesions.
Effort should be made to prevent secondary infection.
Prevent entrance of microorganism into the lesion, especially
if they are broken.
Assess the degree of pain.
Encourage sufficient bed rest and provide supportive care to
promote proper healing of lesions.
Provide the patient with a diversionary activity to take his
mind off the pain and the pruritus.
NURSING DIAGNOSIS
Pain
Alteration of comfort
Body image disturbances
Risk for infection
Impaired physical mobility
Impaired skin integrity
Altered role performances
PREVENTION
Immunization against chickenpox
Avoid exposure to a patient suffering from either varicella or
herpes zoster
Increase the patients immune resistance