Gilut Herpes ZosteR.pptx

8/10/2019 Gilut Herpes ZosteR.pptx

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HERPES ZOSTER

drg. Zaiviani Juniani K, Mkes


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DEFINITION

Herpes Zoster or shingles is an acute

inflammatory viral disease

Etiology

The causative organism is Varicella-

Zoster virus (human herpesvirus 3)


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HERPES ZOSTER (SHINGLES)

Caused by reactivation of a latent varicellazoster virus infection

Can occur years or decades after illness withchickenpox

Generally associated with normal aging andwith anything that causes reducedimmunocompetence

Lifetime risk of 32% in the United States Estimated 1 million cases zoster diagnosed

annually in the U.S.


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CLINICAL FEATURES

The thoracic, cervical, trigeminal, andlumbosacral dermatomes are the mostfrequently affected.

Oral Lesions occur if the second andthird branches of the trigeminal nerveare involved.


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ORAL LESIONS

Itching sensation and pain, which may

simulate pulpitis.

Ulcers heal in 2-3 weeks

Unilateral cluster of vesicles which rupture in

2-3 days, leaving painful ulcers surrounded

by a red zone

Post-herpetic trigeminal neuralgia and

osteomyelitis of the jaw bone are the most

common complication


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SKIN LESIONS

Intense pain associated with pruritus,

tingling, and tenderness

Painful eruption of vesicles or erythematous

bases which develop along a sensory

dermatome

Rash typically involves a single dermatome

and does not cross the midline but mayinvolve multiple dermatomes

Postherpenic neuralgia in 10-15% of cases


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COSTITUTIONAL SYMPTOMS

Fever

Malaise

Headache


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DIAGNOSIS

The diagnosis is usually made clinically

but may be aided by culture. Direct

fluorescent antibody test, serology,PCR.


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DIFFERENTIAL DIAGNOSIS

Herpetic gingivostomatitis

Necrotizing Ulcerative Gingivitis

Varicella Erythema multiforme


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TREATMENT

Patients should be isolated and stay

on the bed for 1 week

The diagnosis should be made andtreatment begun as early as

possible

Immunocompromised patients must

be hospitalized.


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SUGGESTED THER PIES

Antivirals :Valacyclovir 1 g three times dailty for 7 daysand famciclovir 500 mg three times daily for 7days are the drugs of the choice bcause of themore convenient does regimens than acyclovirTraditionally, oral acyclovir 800mg 5times daily

for 7 1 day has been used in treatment ofherpes zoster. High-dose acyclovir (30mg/kg

per day) for at least 7 days is recommendedfor the treatment of herpes zoster forimmunocompromised patients


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Analgesics, transquilizers, tricyclic anti-

depressant, anti-epileptics (carbamazepine,

gabapentin) has been used as a pain relief


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VERICELLA


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HERPES ZOSTER


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Gilut Herpes ZosteR.pptx

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