Shingles is an infection caused by a herpes virus, which carries the consequences of the chicken pox, and is characterized by a lesion of the skin of the nervous system.
It is believed that after the transferred chickenpox, the virus does not disappear from the human body, but continues to live in its nerve spinal ganglia until the end of life. Herpetic rash in this case appears in the course of the nerve coming from the spinal ganglion; On the chest, on the shoulders, etc. Most often, the defeat is one-sided.
As a rule, the rash does not occur spontaneously, for its manifestation, a provoking factor is necessary – hypothermia, stress, infectious diseases. The risk of disease with shingles increases significantly in older age, immunodeficiency states, and also during pregnancy. The rash with shingles is characterized by extremely intense itching, pain, and its treatment is quite difficult. The most effective in this case is a combination of treatment aimed at both internal suppression of the virus and external withdrawal of symptoms.
The herpes zoster causes the Herpesviridae family virus. This virus is quite sensitive to ultraviolet rays, high temperature, but it is stable at low temperatures and withstands repeated freezing. Shingles are very rare (12-15 people per 100 000 population). As a rule, the maximum number of calls falls on the winter season. It was noted that children who had never previously had chickenpox, and who did not observe quarantine in contact with patients with shingles, became ill with it. This again confirms the relationship between these diseases.
During the course of chicken pox, the herpes virus accumulates in the dorsal ganglia, the ganglions of the cranial nerves, where it remains throughout the life in a reactivated state, even in people who have been treated. In them, as well as in areas of skin that are directly related to nerve endings, an inflammatory reaction occurs.
There are data that sometimes the herpes virus is localized both in the posterior and in the anterior roots of the spinal cord, the horns of gray matter, and also the soft meninges. In the latent state of herpes, the virus is from several weeks to several tens of years and may never manifest itself. For the appearance of an appropriate clinic, it is necessary to provoke factors or physiological changes in the body that reduce immunity, such as during pregnancy.
The first period of the disease occurs in the form of general prodromal symptoms – headaches and muscle pains, general malaise, fever up to 37 degrees, etc. As a rule, it lasts no more than 4 days.
Then comes the acute phase of the disease: the temperature rises to 38-39 degrees, there is a pronounced intoxication syndrome, and at the site of the localization of nerve endings, a characteristic rash with intense pain and itching appears. In the beginning, the rash has an exanthematous character, it is pink small spots, in the place of which very small vesicles appear very quickly.
During these changes, lymphadenitis develops, the treatment of which is not required. The rash is localized along the path of nerve endings: on the chest in intercostal spaces, on the face – along the trigeminal nerve, etc. The rashes start to fade at first, the blisters dry out, in place of them there is a crust, which, drying up, leaves a pigmented spot that brightens with time. The entire process takes no more than 3 weeks in the case of uncomplicated flow. The temperature lasts about 5 days, then its decline and decrease in intoxication syndrome is noted.
Isolate the generalized form of the disease, abortive and bullous. The severity of the disease is associated with the localization of herpes zoster and their intensity, the most severe are rashes on the face, eyelids and cornea. The rash is accompanied by burning itching and pain, especially at night. Treatment leads to persistent remission.
During pregnancy, the body’s defenses are significantly reduced and the risk of exacerbation of chronic processes increases. Despite the fact that chicken pox and shingles are caused by the same herpes virus, these are different diseases. Even if a woman complies with quarantine, herpes zoster may occur in her if she already had chickenpox and had a herpes virus in the ganglia.
The clinical picture in pregnant women is the same as in the usual course of the disease, the intensity of manifestation and the clinic of the picture can be both sharply expressed and practically erased. The rash is localized on the chest, face, shoulders and hips.
For the future child, this disease has practically no effect. Immunoglobulins, available in the body of a sick woman, protect the child from the virus. Negative can affect not the effect of the virus itself, but of an intoxication syndrome and the psychological state of a woman. The danger of infection occurs only in the case of rashes before the birth, less than 5 days before the birth of the child. In this case, the risk of chickenpox infection is high, the mortality of the child in this case is quite high, and the treatment of pregnant women is quite difficult.
During the prodromal period, differential diagnosis is performed with diseases of the organs that are in the projection of the affected nerve: appendicitis, renal colic, etc. Before the appearance of rash and neurological disorders, a possible cause of the condition of a pregnant woman can be considered ARVI, ARI and other colds, with the advent of neurological symptoms, there is a risk of mistaken diagnosis of neuritis and neuralgia.
The appearance of rashes makes it necessary to conduct differential diagnosis with other skin infections and herpes simplex infection. The characteristic signs of herpes zoster are: the prodromal period, the linear nature of the eruptions along the course of the nerve endings, the erythematous-vesicular nature of the rashes, the transferred varicella in the anamnesis. In general practice, to do laboratory tests is not necessary, due to the typical picture of the disease.
During pregnancy, a woman should not make her own diagnoses and start treatment. At occurrence of any pathological signs it is necessary to address to the doctor! Treatment can be different. It depends on the severity of the disease, as well as the duration of pregnancy, but it is characteristic for the treatment of herpes simplex infection.
Intravenously drip or in the form of tablets antiviral drug – acyclovir course in 5 days, during the general treatment, local rash is greased with 5% zelenium solution, strengthens immunity with vitamin preparations, uses sedative agents of plant origin, it is recommended to make local lotions with anesthetics in severe pain syndrome.
It is recommended that frequent changes in underwear, hygiene to prevent the attachment of bacterial infection. Preventive measures are not developed for this disease. Do not quarantine for this disease is not advisable.