Also, the disease has definite signs of nervous system. In addition to shingles, the causative agent of the disease - varicella zoster - is able to lead to the appearance of chickenpox in children and adults, without a history of previous data ailment.
What it is?
Shingles - a sporadic disease caused by reactivation of the virus herpes type III (Varicella Zoster virus). The disease is characterized by a primary lesion of the skin and nervous system with severe complications.
Varicella-zoster virus in contact with a human body quickly spread through blood, cerebrospinal fluid and nerve sheath. Settling in the nerve cells of the spinal ganglia, where they persist for life. Hypothermia, sun exposure, alcohol abuse, physical and psychological trauma, hormonal cycles - whatever strikes the immunity provoked exacerbation of the disease. With tropism for the nervous system cells, varicella-zoster viruses cause disease, which often occur on the type of infectious diseases of the central and peripheral nervous systems.
Lifelong latent varicella zoster virus carrier found in about 20% of the inhabitants of our country, had been ill in the childhood chickenpox. Asymptomatic carriage of "dormant" of the virus may be life-long. The main sanctuary for him are the nerve cells of the body. Under the influence of internal and / or external agents that are activated virus.
Story
Shingles was known in antiquity, but was regarded as a distinct disease. At the same time, chicken pox for a long time are often mistaken for smallpox: despite the fact that clinical differences between these two infections have been described in the 60-ies of the XVIII century, a reliable differentiation was only possible in the late XIX century.
The infectious nature of varicella has been proven Steiner in 1875 in experiments on volunteers. Assumptions about the relationship of varicella disease shingles were made for the first time in 1888 by von Bokay, who oversaw the disease chickenpox children after contact with sick herpes zoster. Confirmation of these ideas have received only in the late 1950's. When T. Weller identified pathogen from patients with both clinical forms of the infection.
However, epidemiological data were the most convincing: the incidence of varicella zoster in the centers zoster was significantly higher than the average in the population (in the outbreak of herpes zoster high risk of secondary infection). In 1974, Takahashi and co-workers received attenuated Oka-strain of "wild" virus, and in 1980 a clinical trial of a vaccine against varicella was launched in the United States.
How do you get?
The virus is highly contagious herpes zoster (transferable) so easily spread from person to person by airborne droplets and in contact with the patient's skin. Wherein the body fluid penetrates contained in the bubbles generated on the epidermis of the infected chicken pox or shingles. For the first time an infected person gets chickenpox, then the virus persists in the body for a long time.
Worsening of the disease in the form of herpes zoster may occur due to exposure to a number of precipitating factors:
- decreased immunity, severe immune deficiencies;
- receiving cytotoxic drugs, chemotherapy, cancer;
- autoimmune diseases, pathological disorders in the blood;
- stress, shock;
- poisoning, intoxication;
- prolonged hypothermia;
- advanced age (over 65 years).
Chickenpox - frequent disease in children, with adults having the disease episode in history, can activate the "sleep" virus, contact with the child. Herpes zoster in children under 10 years of age can manifest itself only in the case of congenital disruption of the functioning of immune system cells, as well as transferred in the first months of life chickenpox.
Whether herpes zoster contagious?
When contacting the person as a child had chickenpox, and has developed a strong immunity, the risk of contracting herpes zoster is practically reduced to a minimum. However, in people without a history of prior varicella, contact with a patient with herpes zoster can lead to chickenpox. Especially given the risk increases in children and in adults over fifty years with low immunity.
It should be noted that herpes zoster is contagious during the herpes sores. During the healing and formation of crusts, the disease ceases to be dangerous.
Can I get sick again?
Varicella zoster virus entering the human body, causes chickenpox (varicella). However, after the recovery of the virus is not eliminated, and is stored in the body in a latent state. This virus asymptomatically hides in the nerve cells in the dorsal root of the spinal cord.
Activation of the virus occurs when exposed to the body of negative factors contributing to reduction of immunity. In this case, the disease recurs, not only in the form of chicken pox, and in the form of shingles. Typically, the recurrence of herpes zoster in the future is not observed. In patients with a normal state of health of a relapse of herpes zoster occurs in two percent of cases.
Ten percent of people relapse of herpes zoster occurs in the presence of the following pathologies:
- HIV infection;
- AIDS;
- oncological diseases;
- diabetes;
- lymphocytic leukemia.
In connection with this, to reduce the risk of disease recurrence, as well as for the prevention of herpes zoster vaccine against the virus Varicella-zoster has been released since 2006. This vaccine has shown good results, reducing the risk of developing the disease by 51%.
Symptoms of herpes zoster in adults
How to develop symptoms of the disease depends on the immune system of an adult. The weaker the protection, the more evident effect of the virus. Severe forms are characterized by the appearance of necrotic areas with deep scars, affecting the appearance.
Most often affects the skin of the trunk, a little less - limbs. Rash accompanied by pain, which are often herpes character. They are located on one side.
the initial period
Prodromal characterized malaise, neuralgic pain of varying intensity, it takes an average of 2-4 days:
- Headache
- Low-grade body temperature, sometimes fever up to 39C
- Chills, weakness
- Dyspeptic disorders, gastrointestinal operation
- Pain, itching, burning, tingling sensation in the area of the peripheral nerves in the area where the rash will then.
- In most cases at an acute process become painful and increase regional lymph nodes.
- In severe disease may cause urinary retention and other disorders of certain organs and systems.
After lowering the temperature and weaken other general intoxication disorder.
The period of eruption
A time when there are lesions characteristic of shingles. The symptoms of rash and character depend on the severity of the inflammatory process. First rashes have the form of pink spots foci size of 2-5 mm, between which there remain areas of healthy skin.
- In a typical form of the disease the next day in their place are formed small, closely grouped vesicles, vesicles with clear serous content, which becomes turbid after 3-4 days.
- When gangreneoznoy severe herpes contents of the vials may be mixed with blood, black in color. Herpes have an undulating course, like chickenpox, that is, at intervals of a few days to appear fresh with vesicular rashes elements. Bubbles like crawl from one place to another, belting body, hence the name of this disease.
In milder forms of the inflammatory process in the transformation of the skin nodules and pustules is formed of ulceration does not occur, and it is also possible only manifestation of herpes neurological - pain without rash, otherwise it is called herpetic neuralgia and is often mistaken for symptoms of intercostal neuralgia, osteochondrosis or heartaches. And it can therefore be assigned to inadequate treatment.
During formation of crusts
Usually after 14-20 days at the site of lesions form crust. Whole erythematous background, ie the place where the vesicles gradually becomes pale, dry up, and the yellowish-brown crusts fall away, leaving little pigmentation or depigmentation.
Pain - a formidable symptom of shingles
When the disease of the patient are always marked pain, the intensity of which is from barely perceptible to painful, exhausting the patient, who stopped for a short period under the influence drugs. Most often, pain in the lesions appear on the skin area corresponding to the affected nerve. The intensity of the pain does not always correspond to the severity of skin rash.
After the cessation of exacerbation at 10 - 20% of patients develop post-herpetic neuralgia, which is pain when stored for a long time - from several months to several years. Pain associated with lesions of the intervertebral ganglia viruses traumatic spinal nerves and posterior roots of the spinal cord. Severe disease recorded in lesions of the brain and spinal cord, as well as its membranes. If it affects the autonomic ganglia disrupted the function of internal organs.
atypical symptoms
Symptoms of shingles in atypical forms of flow are expressed in the following forms:
| gangrenous | often it manifests itself in strong and immunodeficiency characterized by enhanced rash that belting location is constantly changing movement. It expresses the constant appearance of new lesions |
| abortive | in this form of bubble rash does not appear in the form of vesicles, but neuralgia remains. |
| bullous | this form of the compound expressed by the vesicles, which are side by side in a single large papules. |
| generalized | with serious violations of the immune system after a typical herpes zoster rash begins to hit large areas of the skin and mucous membranes. |
| cystic | vesicles increase in size, are grouped to form a larger area of lesions on the form with torn borders the lesion. |
Before you treat shingles, make sure it's him. While shingles will not give overt symptoms of the disease it is impossible to determine, since the neuralgic symptoms may indicate other illness.
What is herpes zoster, photos
The photo below shows how the disease manifests itself in adults.
Click to view.
[Fold]
Diagnostics
The prodromal herpes zoster should be differentiated from pleurisy, trigeminal neuralgia, and from acute abdominal syndrome (appendicitis, renal colic, cholelithiasis).
If the rashes are not located along the nerve trunks, the differential diagnosis with herpes simplex, varicella, and bullous form should be differentiated from erysipelas and from skin lesions in immune deficiency and diabetes diabetes.
Treatment of herpes zoster
In adults, shingles can result in spontaneous recovery without medical intervention. However, people with weakened immune systems, elderly patients treated for herpes zoster should be started as soon as possible. This facilitates the severity of the condition and prevent complications of post-herpetic.
Of the antiviral drugs administered to adult patients tablets for 7 - 10 days:
- Zovirax - 2 g / day.
- Acyclovir - 0.8 g x 5 p. in a day.
- Famciclovir - 0.5 g x 3 p. in a day.
- Valaciclovir - 1 x r 3 r. per day.
For the treatment of pain in the early stages of shingles prescribed:
- Aspirin.
- Ibuprofen.
- Anileridine.
- Diclofenac.
- Sufentanil.
- Paracetamol.
Antidepressants for the treatment of HSV-3 with lingering pain assigned as follows:
- Duloxetine.
- Citalopram.
- Mirtazapine.
- Doxepin.
- Maprotiline.
- Clomipramine.
- Escitalopram.
- Venlafaxine.
How to treat herpes zoster to address specific rash? Medicaments external application specialists assigned to antiviral agents further internal use.
Ointments effective against the virus Zoster are Acyclovir, bonafton, Alpizarin, Helepin, Interferon, Epervudin. body treatment gels useful to Allergoferon and Infagel and creams Epigenes, Acyclovir Zovirax.
For drying and disinfecting wounds left after opening herpetic elements Castellani and allowed to apply Zelenka liquid boric acid, Calamine lotion, and Fukortsin Chlorhexidine. Treatment diversify preparations zinc (Badigeon, Tsindol) and a strong solution of potassium permanganate.
Folk remedies
All of the following recipes plant collections (optional) prepared as follows: one tablespoon of herbs to insist in a glass of boiling water 20-30 minutes, cool and use of 1 / 2-1 / 3 cup 2-3 times a day to relieve mild pain and nervous excitability, as well as insomnia.
- The root of valerian, peppermint leaves - 3 parts, watch leaves - 4 parts.
- Mint leaf, watch list - 2 parts, valerian root and hop cones 1 part.
- The fruits of fennel and chamomile flowers - 1 part marshmallow root, licorice root, rhizome of couch grass - 2 parts each (recommended for children).
- Valerian root - 2 parts of chamomile root - 3 parts, fruits cumin - 5 parts.
- Valerian root, hawthorn flowers, mint leaves, grass mistletoe, motherwort herb - 1 part each.
- Valerian root, grass motherwort, straw green oats - 1 part.
- Leaves thistle, green oat straw, fruit cumin - 2 parts, hawthorn flowers, chamomile flowers - 1 part.
- Mint leaves - 1 part herb heather, lemon balm leaves - 2 parts, valerian root - 4 parts.
- The leaves of heather, grass cudweed, herb thyme, valerian root - 2 parts, chicory root - 1 piece.
- Motherwort herb, grass cudweed, grass heather - 2 parts, hop cones, the fruit of cumin - 1 part.
The use of medicinal herbal pharmacopoeia justified in the mild form of the pathogenesis of herpes zoster.
View photo.
[Fold]
Effects
The rapid and painless recovery from herpes zoster caused by the general good condition of health of the patient. Young and strong body with normal immune systems cope better with the virus. In general, the disease is rarely passed without any complications - only 30% of cases. Neuralgic pain after suffering a virus can be stored from six months to several years.
Consequences of shingles can be severe:
- transverse myelitis with the transition to motor paralysis;
- heart failure;
- progression of cancer processes;
- Ramsay-Hunt symptom: paralysis of facial muscles, partial or complete loss of hearing;
- defeat oculomotor nerves;
- brain lesions: encephalitis, aseptic meningitis, meningoencephalitis;
- blindness caused by retinal necrosis.
Improperly treated shingles may acquire relapsing course with subsequent coverage of other nerve trunks. In addition to a neurologist and a skin clinic, be sure to visit immunologist for a competent immune correction.
Vaccination
Against the disease suggested a live vaccine, known as Zostavax.
This vaccine rarely causes side effects, but is contraindicated in patients with weakened immune systems and are not It may be effective in patients taking antiviral drugs active against the virus Varicella zoster. From an economic point of view, it is advisable to use it for patients over the age of 60 years.
In a systematic review of the Cochrane Library of eight randomized, placebo-controlled studies, which covered 52,269 participants, it was found that the vaccine Zostavax in older age groups to prevent one episode of shingles for every 70 vaccinated, that is, it was effective shingles by nearly 50% to reduce the risk. Side effects caused by the vaccine, were presented mostly lungs and moderate symptoms at the injection site [16].
