Herpes Zoster (Shingles)

Robert J. Hyde, MD, MA Reviewed 07/2016
 


BASICS

DESCRIPTION

  • Results from reactivation of latent varicella-zoster virus (human herpesvirus type 3) infection

  • Postherpetic neuralgia (PHN) is defined as pain persisting at least 1 month after rash ...

DIAGNOSIS

HISTORY

  • Prodromal phase (sensations over involved dermatome prior to rash)

    • Tingling, paresthesias

    • Itching

    • Boring “knifelike” pain

  • Acute phase

    • Constitutional symptoms (e.g., fatigue, malaise, heada...

TREATMENT

GENERAL MEASURES

  • Treatment is directed to control symptoms and prevent complications.

  • Antiviral therapy decreases viral replication, lessens inflammation and nerve damage, and reduces the seve...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Referral to ophthalmology if concern for involvement of ophthalmic branch of the trigeminal nerve 

Patient Monitoring

Follow duration of symptoms—particularly PHN. ...

REFERENCES

Yawn BP, Saddier P, Wollan PC, et al. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc.  2007;82(11...

SEE ALSO

  • Bell Palsy; Chickenpox (Varicella Zoster); Herpes Eye Infections; Herpes Simplex

  • Algorithm: Genital Ulcers

CODES

ICD10

  • B02.9 Zoster without complications

  • B02.29 Other postherpetic nervous system involvement

ICD9

  • 053.9 Herpes zoster without mention of complication

  • 053.10 Herpes zoster with unspecified nervous sy...

CLINICAL PEARLS

  • Zoster vaccine is recommended for patients ≥60 years of age and is approved for patients >50 years.

  • Patients with herpes zoster should begin antiviral therapy within 72 hours of the ...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

 
×