HERPES ZOSTER
is a common viral infection of the nerves, which
results in a painful rash of small blisters on a strip
of skin anywhere on the body.
Also called:
•Shingles
•Zone/Zona
•Acute Posterior
Ganglionitis
CAUSATIVE AGENT
Varicella Zoster Virus
MODE OF TRANSMISSION
oDroplet
MANIFESTATIONS OF HERPES ZOSTER
oSame as those of Chicken Pox
oRashes are also VESICULOPUSTULAR
HERPES ZOSTER’S RASHES ARE:
• Not itchy
•More of painful (nerves are affected)
•Pain maybe persistent up to 2 months
(NORMAL)
•UNILATERAL DISTRIBUTION of rashes (follows
the nerve pathway)
•Always VERTICAL and LONGITUDINAL (on one
side)
•Appears in CLUSTER
STAGES OF HZ/SHINGLES
DIAGNOSTIC TEST AND MEDICAL
MANAGEMENT FOR HERPES ZOSTER
o Same as in Chicken Pox
DIAGNOSTIC TESTS:
1. Serological Methods
2. Direct Fluorescent antibody test
3. Polymerase Chain Reaction (PCR) test
4. Tzanck Smear
MEDICAL MANAGEMENT (Antiviral Drugs)
Acyclovir (Zovirax)
Famciclovir
Valacyclovir (Valtrex)
ADDITIONAL MEDICAL MANAGEMENT
Application of POTASSIUM PERMANGANATE
(KMnO4) compress over the rashes of the patient
RATIONALE:
oTo obtain three-fold effect
1. Astringent Effect - to dry the rashes
2. Bacterial Effect - to decrease chance of
skin infection
3. Oxidizing Agent - to deodorize the
rashes and remove fishy odor
IMPORTANT CONCEPT
An attack to HZ does not give permanent
immunity
HZ is caused by a reactivation of the chicken
pox (varicella) virus (lies in the dorsal root
ganglia) after primary infection
Most common complications are:
1. Skin Infection
2. Encephalitis (inflammation of the brain)
PREVENTIVE MEASURE
oSame as that of chicken pox
IMPORTANT CONCEPTS
Children are mostly affected in:
oGerman Measles
oMeasles
oChicken Pox
Adults are mostly affected in:
oHerpes Zoster
NURSING MANAGEMENT
The goals of treatment for patients with shingles/HZ
are to:
1. Minimize the duration and severity of the rash
2. Manage the associated pain
Advise patient not to scratch lesions to reduce the
risk of transmission and avoid scarring, and to
keep lesions clean and dry
Use simple absorbent dressing to cover the rash
(DO NOT USE ADHESIVE DRESSING; can delay
the healing can cause irritation)
Do not use topical antibiotics when secondary
bacterial infection occurs ( Staphylococcus A. &
Streptococcus P.)
Educate the patient about the mode of
transmission of the virus and to encourage him/her
to avoid physical contact with other people
(immunocompromised and infants aged under 1)
Avoid temperature extremes, in both air and
bathwater
Advise patient to wear loosr, nonrestrictive
clothing made of cotton
THANKYOU!!
Group members:
Dumo, Iareen
Duque, H. Angel
Espanto, Dianne