Herpes Zoster (HZV)

Herpes Zoster is an infection which is caused by the Varicella Zoster Virus (VZV), a virus which is highly contagious when airborne or in direct contact with the patient. It lives in a latent form in the dorsal spinal ganglia. Chickenpox is the primary infection of this virus and it typically occurs in children between 5 and 10 years of age; the secondary infection is known as herpes zoster. Herpes Zoster occurs in patients 50+ years of age. Predisposing factors are: old age, stress, immune-suppression and occurrences of neoplasia. There is also a prodromal state with worsening pain in the affected dermatome, accompanied by fever and a general feeling of malaise. An acute stage commences with the formation of vesicles which in the space of a few days is transformed into pustules and scabby ulcers. If the lesions affect the trigeminal branches, intra-oral lesions can also be present. Typical of this pathology is the location of the lesions, which is limited to the facial midline. The ophthalmic branch is especially worrisome in that it can cause blindness . In 15% of cases Herpes Zoster can present as a chronic form, known as post-herpetic neuralgia. Diagnosis is by clinical means and it is facilitated by its typical, paramedian location. A cytological examination of the vesicular fluid is feasible. Treatment is with the use of anti-viral systemic medication and various support therapies.