...Herpes Zoster (Shingles) A 23-year-old female came to the clinic complaining of fatigue and a burning, tingling sensation down the back of her left leg. She stated that it feels like "pins and needles going up and down my leg," followed 2 days later by an eruption of a red bumpy rash which originated on the posterior left thigh. The red bumps became more pronounced and raised over the next couple of days. On examination, the rash had developed into multiple clusters of grouped vesicular lesions and spread from the top of her posterior left thigh, following dermatome S2, and ending at mid-calf. The patient reported having a low-grade fever for the past 2 days, but there were no other signs of infection. The patient complained of intense sharp, stabbing pain and mild itching. She stated that she tried applying a topical anti-itch cooling gel to the rash with no relief for the pain or the pruritis. She denied any exposure to harsh or irritating substances or allergens, such as poison ivy or poison oak. Patient denies prior hospitalizations, surgeries, or accidents. The patient does have a history of exercise induced asthma. During the exam the patient stated that she had had chickenpox when she was a child. Herpes zoster (HZ) or shingles, is an acute inflammatory eruption of incredibly painful vesicles that occur along a band-like unilateral pattern along the course of the peripheral nerves or dermatomes, and does not cross the midline of the body. Shingles results when the...
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...Case Study on Herpes Zoster Case Study on Herpes Zoster History of Present Illness: This is a case of a 27 year old Asian female who came to the clinic complaining of pain on her right hand. She states that it feels like “pins and needles going up to my arm” She denies fever but states that she feels body malaise. She claims to have slight loss of appetite because of the pain. Pain level is about 7-8/10, occurs continuously and is temporarily relieved by Tylenol 500 mg. She noted the appearance of tiny blisters on her hand and upper arm which started about a week ago. The pain according to the patient is described as throbbing and tingling sensation. Patient otherwise has no other complaints. Past Medical History: Patient denies prior hospitalizations, surgeries, accidents. Patient does not remember immunizations but she claims that she never had chickenpox Family History: Both parents are alive. Her father is hypertensive and has coronary arterial disease. Her mother is apparently healthy. She is the only child. Social History: She lives in an apartment with her parents. She works as an employee in the casino. She does not smoke and does not drink alcoholic beverages. Review of Systems: General: Well nourished female, not in acute respiratory distress HEENT: Denies headache. No blurring of vision, hearing not impaired, no sore throat Neck: No tenderness and lymphadenopathy Cardiovascular: No chest pains and palpitations Gastrointestinal: No change in bowel habits...
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...HERPES ZOSTER Herpes zoster (shingles) is a relatively common neurological disorder. Its estimated annual incidence is 3-4 per 1,000 of the general population. The incidence is significantly higher in older people and immunocompromised subjects (irrespective of their age). Herpes zoster is caused by the varicella zoster virus and, typically, develops many years after the patient had recovered from chickenpox. It is thought that at the time of infection with chickenpox the virus migrates from the skin to the sensory ganglia via the axons of peripheral nerves and remains dormant in the ganglia, usually for many years. Activation of the virus occurs when the subject’s cell immunity is reduced. The activated virus travels along the sensory nerve...
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...Bell's palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) causing an inability to control facial muscles on the affected side. Often the eye in the affected side cannot be closed. The eye must be protected from drying up, or the cornea may be permanently damaged, resulting in impaired vision. In some cases denture wearers experience some discomfort. The common presentation of this condition is a rapid onset of partial or complete paralysis that often occurs overnight. In rare cases, it can occur on both sides resulting in total facial paralysis. Bell’s palsy is defined as a one-sided facial nerve paralysis of unknown cause. Several other conditions can also cause facial paralysis, e.g., brain tumor, stroke, myasthenia gravis, and Lyme disease; however, if no specific cause can be identified, the condition is known as Bell's palsy. It is thought that an inflammatory condition leads to swelling of the facial nerve. The nerve travels through the skull in a narrow bone canal beneath the ear. Nerve swelling and compression in the narrow bone canal are thought to lead to nerve inhibition or damage. Usually it gets better on its own with most people achieving normal or near-normal function. Corticosteroids have been found to improve outcomes, when used early, while anti-viral drugs have not.[3][4] Many show signs of improvement as early as 10 days after the onset, even without treatment. Bell's palsy is the most common acute...
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...The varicella-zoster virus (VZV), a DNA virus that causes chickenpox, is one of eight herpesviruses that can infect humans (Arvin 2008). Chickenpox is a contagious disease with symptoms of itchy red rashes (which can lead to skin infections) fatigue, and a fever (Centers for Disease Control and Prevention 2011). VZV causes chickenpox by entering into the respiratory tract and multiplying in the lungs and in regional lymph nodes. After the primary infection of the chickenpox, the virus goes dormant in the nerves and then the immune system stops responding to it. However, VZV can reactivate to cause herpes zoster to appear many years later (also known as shingles which has similar but mild symptoms to chickenpox) (Nagel and Gilden 2007). The immune system responses to the primary varicella-zoster virus by, first, using the innate immune system with the release antiviral cytokines and activation of the NK cells (Arvin 2008). In response, the NK cells release IFN-γ (a pro-inflammatory cytokines), which...
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...Chickenpox Pamela Nauerth Grand Canyon University April 20, 2014 Chickenpox Varicella infection, commonly known as Chickenpox, is a member of the herpes virus group. Varicella has the capacity to stay latent in the human source. It stays in the sensory nerve ganglia and the recurrent infection is called Herpes Zoster or Shingles. This essay gives the description, causes, symptoms, mode of transmission and the treatment of varicella. It describes the mortality, morbidity, incidence and prevalence of the disease. It explains the determinants of health and how they contribute to the development of varicella. This essay discusses the epidemiologic triangle and how it relates to chickenpox. It explains the role of the community health nurse regarding their case findings, reporting, data collecting, data analysis and the follow-up related to chickenpox. It identifies on great national agency that addresses the virus and describes contributes to resolving and reducing the impact of the disease. Varicella was confused with smallpox until the late eighteenth century. Rudolf Steiner was scientist who discovered that varicella virus was caused by an infectious agent in 1875. Steiner removed fluid from the blisters of chickenpox and put it on the skin of volunteers that were healthy. It resulted in the volunteers to contract the virus (Centers for Disease Control and Prevention [CDC], 2012). The symptoms of the virus develop about 15 days after being exposed to an...
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...morbidity, incidence, and prevalence of the disease. The determinants of health will be described, and the factors that add to the progression of the disease. The epidemiologic triangle, as it relates to Varicella, will be examined, including host factors, absence or presence of agent factors, along with environmental influences. The role of the community health nurse will be discussed as related to case finding, data collecting, reporting, data analysis, and follow-up. Lastly, a national agency or organization will be revealed that addresses chicken pox, and how it contributes to resolving or reducing the impact of the disease on the public. The infectious disease of varicella, or chicken pox, is very contagious. A virus named varicella-zoster causes it. Furthermore, chickenpox can also be spread from those who have shingles. Since the same virus causes shingles, caution should be taken since an individual with shingles can infect those who have never had chickenpox, or those who have not been vaccinated against the disease. People most at risk to contract the disease are those who have not had the disease before, or received chicken pox vaccine. People who contract the virus can expect it to last anywhere from five to ten days. The most common indication of the infectious disease is a rash the turns in to an outbreak of fluid-filled blisters that frequently itch profusely, and ultimately scab over. The timeframe of being contagious to others ranges from one to two days...
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... Petruzelli (1991) states that Bell’s palsy is an acute paralysis of the facial nerve first described by the Scottish surgeon and anatomist, Sir Charles Bell . Niparko (1993) elaborates that it is a generally unilateral paralysis or weakness of facial musculature consistent with facial nerve damage and dysfunction. The anatomy of the facial nerve can be found in appendix two. Pietersen (2002) states that the cause is unknown, however, whilst the exact aetiology of Bell’s palsy is still debated, viral infections, vascular ischaemia, autoimmune inflammatory disorders and heredity have been postulated as causative. (Adour 1982, Burgess 1984, Lorber 1996). Murakami et al (1996) proposed that reactivation of herpes simplex virus in the geniculate ganglia was causative. A herpes simplex cause is corroborated by Stjernquist-Desatnik, Skoog, and Aurelius (2006). Whilst the exact aetiology is disputed, a greater consensus is reached when considering the pathophysiology. Tiemstra and Khatkhate (2007) state that Bell’s palsy is thought to be caused by inflammation at the geniculate ganglion. This appears corroborated by Fisch and Esslen (1972) who noted oedematous swelling proximal to the...
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...This paper will provide information about the Varicella Zoster Virus (VZV), starting from the historical aspects of it and ways on how to treat this infection. The Varicella Zoster Virus is a virus that causes two different infections: varicella and herpes zoster. Most people know varicella as chickenpox. The first sign of varicella is a rash. Red, itchy spots begin to appear over the face, ears, scalp, abdomen, chest, back, arms, legs, basically anywhere on the body. The spots eventually develop into vesicles, also known as blisters, that are filled with clear fluid. The vesicles gradually dry out and scabs begin to form. These scabs eventually fall out without leaving any scar. Herpes zoster is an infection that occurs after varicella has occurred; it is commonly known as shingles. Herpes zoster involves a nerve and the area of skin supplied with that nerve. Similar to varicella, shingles also leads to a development of red rash, but it is...
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...Shingles What is shingles? Shingles is a medical condition characterized by reactivation of varicella zoster virus. Varicella zoster is the virus responsible for chicken pox – this disease frequently affects toddlers and presents with diffuse bodily rash with blisters. After contracting this disease, the virus regressed and remains dormant in nerve cells called the dorsal root ganglia. These bundles or ganglia of cells house varicella zoster until a period of time when the body becomes stress or the immune system suppressed. This causes the virus to wake up or reactivate, and travel down nerve dermatomes where they produce painful blisters and rash. This usually occurs on one side of the body. If it involves the face, it may lead to...
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...SeAnna Brantley Microbiology Case Studies 1.1-1.8 Case 1.1 1. The fertility specialist recommended the rubella vaccine because if the rubella virus is contracted early in pregnancy there is an increased risk of miscarriage or birth defects such as deafness, cataracts, mental retardation, heart defects, liver and spleen damage. There are contraindications related to conceiving within four weeks of receiving the rubella vaccination because it is a “live” vaccine and could still cause complications. 2. In the United States it is recommended that children receive the first dose of the MMR (measles, mumps rubella) vaccination between 12-15 months (not earlier) and then to receive a second dose around 4-6 years of age. 3. The client’s description does not correlate with the rubella virus. Symptoms of the rubella infection typically only last 3 days and are often referred to as the “3 day measles”. 4. In order to check the immune status of the client the test would be checking for IgG antibodies. The absence of IgG rubella antibodies indicates that the person has likely not been exposed to the rubella virus or vaccine. IgG are also the only antibodies that can cross the placenta to protect the fetus. 5. To test for a current rubella infection using only the IgG antibody test the physician should order the initial IgG for a baseline and then perform the test again in 2-3 weeks to check if there was a significant increase (titer) present. An increase would indicate recent or current...
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...Shingles Keonna White December 19, 2013 Anatomy & Physiology Introduction of Shingles If you have had chickenpox during your childhood, it is sure that the virus has stayed in your system for numerous of years. But the virus has then been reactivated in later life, and that’s what causes the skin disease called “Shingles,” to develop. As well as chickenpox, there are other diseases which weakens our immune system. For example, HIV and/or AIDS can also cause Shingles to develop. Shingles is not considered a life threatening virus, but can become quite painful. Shingles is an extraordinarily painful condition that involves inflammation of sensory nerves. Symptoms The symptoms of Shingles include a tingling and irritated burning feeling to the skin, but it usually appears down one side of your body. And it also includes a nasty, painful red rash in the form of a band, and develops after a few days. Shingles may consist of nerve pain in the face, feverish system, headache, arm and leg pains, and also swelling. You may have a general feeling of being unwell and serious aches and pains. While the shingles rash may appear anywhere on the body, it most often appears around the waistline or side of the butt. Even when there is no rash, the pain of shingles may be apparent. Before a rash is visible, the patient may notice several days to a week of burning pain and sensitive skin. Shingles rash starts as small blisters on a red base, with new blisters continuing to...
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...Infectious Disease (Shingles) Tomakio Robinson February 3, 2012 Jessica Grippo HCA/240 Shingles virus which the medical terms use is herpes zoster, which is accompanied by a local rash and pain. Shingles virus usually covers certain areas of the skin encompassing about one to three dermatomes. The dermatome area is supplied by just one single nerve root, shingles is known by blisters superimposed by an aggressive red inflamed base. Shingles virus only occurs on one side of the body, the pain of shingles is very severe and those who have experienced the shingles virus describe shingles as a burning sensation. The area of the body which is affected by shingles virus becomes very sensitive to the touch which is medically known as allodynia. When allodynia is present many people usually wear loose fitting clothing because shingles are very painful. Shingles is a reaction of varicella-zoster virus, which is a form of herpes that causes chickenpox. Once a person has had chickenpox, the virus from the chickenpox remains in the nerve roots and remain inactive until it begins to flare up again; but this time instead of chickenpox the individual will get shingles. If someone has ever had a mild case of chickenpox can catch shingles. Any individuals with a weak immune system are very vulnerable to activating the virus that forms shingles. There are many ways the immune system can become weak such as recent surgeries, medications, serious illness or disease and poor nutrition...
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...by a virus called varicella-zoster which has a resemblance with the herpes virus. It can be transmitted through close contact with the fluids from the blisters or through air wherein the virus is disseminated by coughing or sneezing. Chickenpox is regarded as highly communicable for individuals who are exposed to the disease for the first time has an 80% risk of acquiring the disease through close contact of an infected individual. As claimed by the Pub Med Health, “most children with chickenpox exhibit symptoms like fever, headache, stomach ache, loss of appetite, or presence of small, fluid-filled, itchy, red spots over the skin.” At the time when the chickenpox blisters has dried and formed scabs is the point where the individual isn’t contagious. Each and every individual is at risk of being infected by chickenpox – no exception. It is known to have life threatening effects. As the Directors of Health Promotion and Education states, “in the United States, 4,000 to 9,000 individuals are hospitalized annually with chickenpox, with approximately a hundred casualties. Those at highest risk for complications are newborns, individuals with compromised immune system, and adults.” As chickenpox is caused by a virus, it has no cure and the virus would remain in our system for a lifetime even after we’ve done exhibiting the signs and symptoms of the illness. Furthermore, the virus can induce another kind of illness called shingles. As the varicella-zoster virus shifts into the skin...
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... NU1426 My patient is a patient that is leaving the E.R. after being diagnosed with the shingles virus. The patient came into the E.R. with a rash on the right side of the trunk. The rash presented as clear blisters and was painful to the touch. The physician diagnosed the patient with shingles and it is now my job to explain to the patient about the shingles virus. I would start by explaining that the painful rash is called the shingles virus. It is caused by the same virus that causes chicken pox and it is called herpes zoster. If they had the chicken pox as a child the virus has been in there body since they had them. It is an infection of the nerve. The virus presents usually on the trunk or side of the body but can present in other areas but that the rash they are experiencing is in the most common place. I would give the patient an overview of the symptoms. I would explain that the virus can cause clear blisters that are filled with liquid. These blisters will eventually burst and the skin will be red and sore and will scab or crust over. The rash will go from being itchy to painful to the touch. In some cases a low fever can occur. I want to make sure the patient knows these symptoms are normal. I want the patient to know that the actual...
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