Today in medicine, many cases of infection with viral infections of different genesis are diagnosed. For example, the Zoster herpes virus is often found in children, it is he who provokes the development of chickenpox. Having once penetrated the human body, he never leaves him. After curing chickenpox, the virus goes into an inactive state, settling in the cells of the nervous system. After many years, it can activate and begin to move along the nerve endings, provoking the development of an infection of the skin of that part of the body that 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 provokes the development of shingles. The disease is quite contagious, but in 90% of cases it is observed 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 ulcers, which constantly itch. When combing, they burst and dry out, forming crusts. The Herpes Zoster code for ICD-10 has B02.
The infection is transmitted by airborne droplets. Once in the respiratory system, the virus multiplies, gets to the lymph nodes, provoking the development of primary viremia. Over time, Herpes Zoster spreads throughout the body with a flow of lymph and blood, as well as along the nerve processes, which is why its life span in the human body is determined.
The latent period of the disease is about twenty days. Then, herpes Zoster (ICD-10 is 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 goes onto the torso. Extremities are affected in rare cases. Five days later, new rashes form, accompanied by itching and pain. After four weeks, self-healing usually occurs. In some cases, pain and itching can be observed in a person several 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 reoccur in people with HIV infection or a weakened immune system. Typically, the number of infected increases in the winter. Mostly people who suffer from chickenpox are sick.
When healthy children who have not previously been infected with the virus come into contact with sick people, they develop normal chickenpox.
Causes of the disease
Herpes Zoster (code ICD-10 - V02) is transmitted to a healthy person from an infected person by airborne droplets. The virus infects the cells of the skin and nervous system, causing the development of chickenpox. After curing a person of chickenpox, herpes goes into an inactive state. Its activation occurs with a decrease in human immunity, which may be caused by:
- taking medications that reduce the body's defenses (antibiotics, cytostatics and glucocorticosteroids);
- prolonged stress and depression;
- severe hypothermia;
- oncological diseases;
- complications after radiation therapy;
- surgical interventions in which the virus enters the body through a wound;
- non-compliance with the regime of the day and nutrition;
- long-term inflammatory processes of unclear etiology in the body;
- HIV infection and AIDS;
- transplantation of donor organs.
An obligatory element of virus activation is inflammation of the nerve nodes and the posterior roots of the spinal cord. Herpes can provoke the development of meningitis, encephalitis, various diseases of the internal organs.
The risk group includes elderly people, pregnant women, HIV-infected.
Symptoms of the disease
Symptoms of Zoster herpes appear in the form of a pink rash, each spot up to five centimeters in diameter. Rashes are localized along the nerves. After a day, painful vesicles form in their place. The main feature of the disease is a clear delineation of the affected area. Most often, the rash appears in the chest area, but can also be located on one side of the body along the line of passage of the nerves.
These manifestations are preceded by an increase in body temperature, weakness and malaise, itching, pain of a neurological nature in the place where rashes will appear in the future. The disease is accompanied by an increase in lymph nodes.
Four days later, bubbles with a clear liquid appear on the site of the vesicles, which burst and dry eight days later, forming yellow crusts. These crusts disappear over time, leaving behind age spots. Symptoms of the pathology usually disappear on their own four weeks after the manifestation, but pain and itching can remain in the person for a long time.
Symptoms of Zoster herpes can occur in slightly different ways 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 brain arteries, leading to the development of hemiplegia - paralysis of the limbs.
Stages of the development of the disease
The disease goes through three stages:
- The prodromal stage is characterized by the penetration of the virus into nerve cells and their fixation.
- Stage of rash formation.
- Stage of regeneration. It begins when crusts form at the lesion sites.
In severe cases, the disease leads to disability.
Complications and consequences
The virus can cause the development of the following pathologies:
- ophthalmic herpes - a pathology that is characterized by damage to the cornea of the organs of vision;
- Remsay Hunt disease. Symptoms: the development of facial paralysis, rashes in the ear canal and pharynx, dizziness, deterioration or loss of hearing;
- transverse myelitis, in which motor paralysis is observed;
- the spread of the rash throughout the skin;
- purulent skin diseases caused by the attachment of a secondary infection;
- pneumonia, which increases the risk of death during the course of the disease up to 10 percent;
- hepatitis A;
- myocarditis.
With damage to the organs of vision, keratitis, conjunctivitis, blepharitis develops. In severe cases, pathology provokes complete loss of vision. With damage to the organs of hearing, its complete loss is often observed.
Forms of the disease
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. At the site of rashes, redness is observed.
- A bullous form in which blisters with uneven edges appear on the skin, which eventually merge into one large bloody bladder.
- Hemorrhagic herpes causes the formation of blisters, inside of which there is bloody content. When wounds heal, scars form.
- The necrotic form manifests itself in the form of tissue necrosis. The disease usually develops in people with diabetes and a stomach ulcer.
- The generalized form is characterized by the formation of vesicles, which are observed throughout the body.
- Meningoencephalitis form is the most dangerous, as it often leads to death. The disease is characterized by the rapid course and development of meningoencephalitis.
Diagnosis of ailment
Herpes Zoster (ICD-10 includes diseases with and without complications) is usually diagnosed without difficulty. First, the doctor studies the anamnesis and examines the patient, in which he notes the nature of the rash, pain, localization of the lesion sites. During the survey, the doctor finds out the time of symptoms and 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 is extremely rare.
The patient is prescribed laboratory tests of blood and urine, a study of fluid from the blisters. Often, PCR (polymerase chain reaction) is required, especially in the absence of skin manifestations of pathology. If the test is positive, they speak of virus activation. An enzyme-linked immunosorbent assay and bacteriological culture are also often used.
The doctor should distinguish herpes Zoster from diseases such as herpes simplex, erysipelas, eczema, which have similar symptoms.
Disease treatment
The effectiveness of the treatment depends on how early the diagnosis was made. In most cases, the disease goes away on its own a month after the onset of symptoms. However, an effective treatment of pathology in medicine has been developed, it can not only facilitate the manifestation of pathology, but also reduce the risk of complications. Zoster herpes treatment is aimed at accelerating the healing process, relieving pain, preventing complications, as well as reducing the risk of neuralgia.
People who are prone to developing complications need medication. In healthy young people, the disease goes away without taking medication.
With a mild form of pathology, treatment is carried out at home, hospitalization is indicated in case of development of the ocular and ear forms of the disease, as well as with suspected brain damage.
Drug treatment
Zoster herpes treatment is carried out by the following groups of medicines:
- Antiviral agents to fight the causative agent of infection. Most often, the doctor prescribes drugs such as Acyclovir or Valaciclovir. These drugs help stop the replication of the virus through the incorporation of their molecules into viral DNA. Medicines of this group provide an opportunity within three days from the onset of symptoms to reduce their severity, thereby reducing the duration of the disease. Also in this case, you can apply Infagel, which is applied to damaged areas of the skin. Bubbles burst faster, and crusts begin to appear on the third day.
- Immunomodulators to strengthen the body's defenses.
- Painkillers are prescribed in order to stop pain, normalize breathing and physical activity, and eliminate psychological discomfort. Doctors often prescribe Ibuprofen or Ketolorak. With the development of neuralgia, Amatadine is prescribed.
- Anticonvulsants are used to eliminate the neuropathic pain caused by herpes Zoster (ICD-10 code is listed 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.
Herpes Zoster is also treated with diet and physiotherapy. Quartz, electrophoresis, diathermy are often prescribed to speed up the healing process.
To treat the rash, you can use zelenka, boric acid or potassium permanganate, as well as Castellani and Fukortsin. But all these medicines are recommended to be applied carefully, since too much of any of them can lead to burns.
Forecast
The disease has a favorable prognosis provided timely treatment is started. With the development of the meningoencephalitis form of the pathology, the prognosis will be unfavorable, often this kind of disease leads to death, especially in the absence of adequate treatment. Therefore, it is important to immediately seek the help of a doctor if you suspect the presence of this herpes virus.
Usually, in 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 course of the inflammatory process, the disease can reoccur in the future, so it is very important to strengthen the immune system so as not to miss the 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 for people who have HIV and AIDS, as well as those who use antiviral drugs for chickenpox. Typically, this vaccine is recommended for the elderly. It is worth noting that the vaccine does not give a one hundred percent guarantee - it is able to prevent the development of pathology in half 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 skin is treated with gloves. With a severe course of the disease, bed rest is necessary. Water treatments and sun rays are contraindicated, as they contribute to the spread of rash.
Herpes zoster, or herpes Zoster, was known in ancient times, but then its nature was not yet understood. The hypothesis about the relationship between chickenpox and 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.