HERPES ZOSTER

Contact with infective vesicular fluid

Chickenpox infection

Varicella Zoster virus lays dormant inside the nerve cells near the
Brain and Spinal Cord

Weakened immune system (AIDS)

Malignancies (leukemia, lymphomas)

Reactivation of the latent Varicella (“chickenpox”) Virus

[Clinical course – 1 to 3 weeks]

Itching and Malaise GIT disturbances

tenderness Pain
over the area Eye
Radiates over the entire region supplied complication
by the nerves, burning, lancilating
(tearing, sharply cutting),
stabbing or aching. Postherpetic
Neuralgia

Eruption / blisters INFECTION

“ZOSTERIFORM LESIONS”
(Usually confined to a narrow region of face –nose, lips, cheeks,
ears or trunk or genetalia and is unilateral – cervical, thoracic, or
cranial nerve in band-like configuration)

Papules Red swollen skin

(“erythematous base”)

Vesicles with serum (early)

Purulent vesicle (later)

Crust Vesicles rupture

(7-26 days –healing time)
 PAIN IN HERPES ZOSTER

Eye complication Postherpetic Neuralgia

Ophthalmic Nerve
“GASSERIAN GANGLIONITIS”

Ophthalmic Herpes Zoster

Facial Nerve Acoustic Nerve
“RAMSAY HUNT
Uveitis SYNDROME”
Keratitis
Ulceration
Blindness

Def.: Inflammatory viral condition in which the virus produces

painful vesicular eruption along the area of distribution of the
sensory nerves from one or more posterior ganglia (Brunner &
Suddarth).
An infection caused by reactivation of Varicella virus in
clients who have had chicken pox (Joyce M. Black).

Causative Agent: Varicella Zoster Virus

Management:
GOAL: 1] To relieve pain.
2] To reduce or avoid complication.

PAIN
 Analgesics
 Corticosteroids – prescribed for patients over age 50 to
reduce incidence and duration of Postherpetic neuralgia.
 Anti-inflammatory – Triamcolone (Aristocort, Kenacort,
Kenalog) – injected subcutaneously.
CHRONIC PAIN – Tricyclic antidepressants, Phenothiazines,
Electrical Stimulation (ES).
INFECTION
 Antiviral (Vidarabine, Valtrex) – Acyclovir (Zovirax) – oral
w/in 24 hrs. – arrest progression
o Early IV – effective in reducing pain and halting disease.