Today in medicine, many cases of infection with viral infections of various genesis are diagnosed. For example, the herpes Zoster virus is often found in children, it is he who provokes the development of chicken pox. Having penetrated once into the human body, it never leaves it. The virus after curing chickenpox goes into an inactive state, settling in the cells of the nervous system. After many years, it can be activated and begin to move along the nerve endings, provoking the development of an infection of the skin of that part of the body that the damaged neurons innervate. Thus, the herpes virus manifests itself in the form of shingles, which is characterized by rashes, itching and pain.
Problem description
Herpes Zoster is a virus that causes the development of shingles. The disease is quite contagious, but in 90% of cases it occurs in childhood and adolescence, and only 10% of cases occur in adults. The disease is characterized by the appearance of rashes on the skin. A small rash transforms into blisters, and then abscesses that constantly itch. When combed, they burst and dry out, forming crusts. HerpesZoster code according to ICD-10 has B02.
Infection is transmitted by airborne droplets. Once in the respiratory system, the virus multiplies, reaches the lymph nodes, provoking the development of primary viremia. Over time, Herpes Zoster spreads throughout the body with the flow of lymph and blood, as well as through the nerve processes, which is the reason for its lifelong presence in the human body.
The latent period of the disease is about twenty days. Then herpes Zoster (ICD-10 indicated above) is manifested by an increase in the patient's body temperature and the appearance of the first rashes on the skin. First, the rash appears on the head and face, then it moves to the trunk. The limbs are rarely affected. Five days later, new rashes form, accompanied by itching and pain. It usually heals on its own after four weeks. In some cases, pain and itching can be observed in a person for several more years after treatment, in this case they speak of postherpetic neuralgia.
Epidemiology
Herpes Zoster (photo below) is diagnosed in twelve people out of a hundred thousand. Pathology can occur repeatedly in people with HIV infection or a weakened immune system. Usually the number of infected increases in the winter. Mostly people who had chickenpox in childhood are sick.
Chickenpox develops when he althy children who have not previously been infected with the virus come into contact with sick people.
Causes of disease development
Herpes Zoster (ICD-10 code - B02)transmitted to a he althy person from an infected person by airborne droplets. The virus infects the cells of the skin and nervous system, provoking the development of chicken pox. After curing a person from chickenpox, herpes goes into an inactive state. Its activation occurs when a person's immunity decreases, the reasons for which may be:
- taking medications that reduce the body's defenses (antibiotics, cytostatics and glucocorticosteroids);
- prolonged stress and depression;
- severe hypothermia;
- oncological diseases;
- complications after radiotherapy;
- surgical interventions in which the virus enters the body through a wound;
- non-observance of the daily routine and nutrition;
- long-term inflammatory processes of unknown etiology in the body;
- HIV and AIDS;
- donor organ transplant.
An obligatory element of virus activation is inflammation of the nerve nodes and dorsal roots of the spinal cord. Herpes can provoke the development of meningitis, encephalitis, various diseases of internal organs.
The risk group includes the elderly, pregnant women, HIV-infected people.
Symptoms of the disease
Symptoms of herpes zoster appear as a pink rash, each spot up to five centimeters in diameter. Rashes are localized along the nerves. A day later, painful vesicles form in their place. The main feature of the diseasethere is a clear demarcation of the affected area. Most often, the rash appears in the chest area, but it can also be located on one side of the body along the line of nerve passage.
These manifestations are preceded by an increase in body temperature, weakness and malaise, itching, neurological pain in the place where rashes will appear in the future. The disease is accompanied by an increase in lymph nodes.
After four days, blisters with a clear liquid appear at the site of the vesicles, which burst and dry up after eight days, forming yellow crusts. These crusts fall off over time, leaving behind age spots. Symptoms of pathology usually disappear on their own four weeks after the onset, but pain and itching can remain in a person for a long time.
The symptoms of herpes zoster may present slightly differently in people who have HIV or AIDS. In this case, in addition to rashes, the disease provokes the development of encephalitis, damage to the spinal cord and arteries of the brain, leading to the development of hemiplegia - paralysis of the limbs.
Stages of disease progression
The disease goes through three stages:
- The prodromal stage is characterized by the penetration of the virus into nerve cells and fixation in them.
- Rash formation stage.
- Regeneration stage. It starts when crusts form in the affected areas.
In severe cases, the disease leads to disability.
Complications and consequences
The virus can causedevelopment of the following pathologies:
- ophthalmic herpes - a pathology that is characterized by damage to the cornea of the organs of vision;
- Remsey-Hunt disease. Symptoms: development of facial paralysis, rashes in the ear canal and pharynx, dizziness, deterioration or loss of hearing;
- transverse myelitis, in which there is motor paralysis;
- spread of rash all over the skin;
- purulent skin diseases caused by the addition of a secondary infection;
- pneumonia, which increases the risk of death during the course of the disease by up to 10 percent;
- hepatitis;
- myocarditis.
When the organs of vision are affected, keratitis, conjunctivitis, and blepharitis develop. In severe cases, pathology provokes a complete loss of vision. With damage to the hearing organs, there is often a complete loss of it.
Disease forms
The herpes zoster virus can manifest itself in the following forms of rashes:
- The abortive form is characterized by the appearance of blisters with no pain syndrome. Redness is observed at the site of the rash.
- A bullous form in which blisters with jagged edges appear on the skin, which eventually merge into one large bloody blister.
- Hemorrhagic herpes causes the formation of blisters, inside of which there is bloody contents. When wounds heal, scars form.
- The necrotic form manifests itself in the form of tissue necrosis. The disease usually develops in people with diabetes andstomach ulcer.
- The generalized form is characterized by the formation of vesicles that are observed throughout the body.
- Meningoencephalitic form is the most dangerous, as it often leads to death. The disease is characterized by a rapid course and the development of meningoencephalitis.
Diagnosis of disease
Herpes Zoster (ICD-10 includes diseases with and without complications) is usually diagnosed without difficulty. First, the doctor studies the history and examines the patient, in which he notes the nature of the rash, pain syndrome, and the localization of the lesions. During the survey, the doctor finds out the time of manifestation of symptoms, as well as the possibility of contact with the carrier of the infection. In some cases, the doctor may mistakenly make a diagnosis at the first stage of the development of the disease, but this happens extremely rarely.
The patient is assigned laboratory blood and urine tests, a study of the fluid from the blisters. Often, PCR (polymerase chain reaction) is required, especially in the absence of skin manifestations of pathology. With a positive result of the analysis, they speak of the activation of the virus. ELISA and bacteriological culture are also often used.
The doctor must distinguish herpes zoster from diseases such as herpes simplex, erysipelas, eczema, which have similar symptoms.
Cure disease
The effectiveness of treatment depends on how early the diagnosis is made. In most cases, the disease resolves on its own within a month of the onset of symptoms. Howevereffective treatment of pathology in medicine has been developed, it can not only alleviate the manifestation of pathology, but also reduce the risk of complications. Herpes Zoster treatment is aimed at accelerating the healing process, relieving pain, preventing complications, and reducing the risk of developing neuralgia.
People who are prone to developing complications need drug therapy. He althy young people get better without medication.
In a mild form of pathology, treatment is carried out at home, hospitalization is indicated in case of development of the eye and ear forms of the disease, as well as in case of suspected brain damage.
Medicated treatment
Treatment of herpes Zoster is carried out by the following groups of medicines:
- Antiviral agents to combat the causative agent of infection. Most often, the doctor prescribes drugs such as Acyclovir or Valaciclovir. These drugs help stop viral replication by incorporating their molecules into viral DNA. Medicines of this group make it possible to reduce their severity within three days from the onset of symptoms, thereby reducing the duration of the course of the disease. Also in this case, you can use "Infagel", which is applied to damaged areas of the skin. Bubbles burst faster, while crusts begin to appear on the third day.
- Immunomodulators to strengthen the body's defenses.
- Painkillers are prescribed to stoppain syndrome, normalize breathing and motor activity, eliminate psychological discomfort. Doctors often prescribe "Ibuprofen" or "Ketolorac". With the development of neuralgia, "Amatadin" is prescribed.
- Anticonvulsants are used to treat neuropathic pain caused by herpes zoster (ICD-10 code above). In this case, the doctor may prescribe Pregabalin.
- Glucocorticosteroids are prescribed to reduce itching and inflammation. This group of drugs, together with antiviral drugs, makes it possible to quickly eliminate the symptoms of the disease in its mild form.
- Antidepressants to relieve nervous tension.
- Vitamin complexes, in particular vitamins A, C and E. These vitamins can reduce the inflammatory response and restore epithelial cells.
Also, herpes zoster is treated with diet and physiotherapy. Often, quartz, electrophoresis, diathermy are prescribed to speed up the healing process.
To treat a rash, you can use brilliant green, boric acid or potassium permanganate, as well as Castellani and Fukortsin. But all these medicines are recommended to be applied carefully, as too much of any of them can lead to burns.
Forecast
The disease has a favorable prognosis, subject to timely treatment. With the development of the meningoencephalitis form of pathology, the prognosis will be unfavorable, often this type of disease leads to death, especially in the absence ofadequate treatment. Therefore, it is important to immediately seek help from a doctor if you suspect the presence of this herpes virus.
Usually, with mild forms of the disease, relapses do not occur, there are no serious complications in this case. In people who have weak immunity, after the inflammatory process, the disease may recur in the future, so it is very important to strengthen the immune system in order not to miss a relapse.
Prevention
Herpes Zoster, the symptoms and treatment of which are described above, can be prevented by vaccination. In medicine, this procedure is known as Zostavax. This vaccine is designed to prevent the development of the disease. But this drug is contraindicated in people who have HIV and AIDS, as well as those who use antiviral drugs for chickenpox. This vaccine is usually recommended for the elderly. It is worth noting that the vaccine does not give a 100% guarantee - it is able to prevent the development of pathology in half of the cases.
In order to prevent the spread of infection, it is recommended to isolate people who have shingles. In the room where the patient is located, it is necessary to carry out wet cleaning daily. Linen should be regularly changed, washed and ironed. The affected areas of the skin are treated with gloves. In severe cases of the disease, bed rest is necessary. Water procedures and sunlight are contraindicated, as they contribute to the spread of the rash.
Shingles, or herpes zoster, was known in ancient times, but then its nature was not yetunderstandable. The hypothesis about the connection of chickenpox with herpes was proposed back in 1888, but only sixty years later this connection was confirmed by scientists. Today, the disease is successfully treated, complications are possible only in the absence of therapy.
