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Herpes zoster infection

Last reviewed: 25 Jun 2024
Last updated: 06 Mar 2024

Summary

Definition

History and exam

Key diagnostic factors

  • localized pain in a dermatome
  • pruritus
  • rash
  • corneal ulceration
Full details

Other diagnostic factors

  • fever
  • headache
  • malaise
  • fatigue
  • pain without rash
Full details

Risk factors

  • >50 years of age
  • female sex
  • HIV
  • chronic corticosteroid use
  • chemotherapy
  • malignancies
  • white ethnicity
  • certain acute or chronic conditions
  • vaccination against other infectious diseases
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
Full details

Tests to consider

  • polymerase chain reaction (PCR)
  • immunohistochemistry
  • vesicular fluid culture
  • HIV test
Full details

Treatment algorithm

ACUTE

acute symptoms: immunocompetent

acute symptoms: immunocompromised

ONGOING

postherpetic pain

Contributors

Authors

Phuc Le, PhD, MPH

Assistant Professor

Center for Value-Based Care Research

Medicine Institute

Cleveland Clinic

Cleveland

OH

Disclosures

PL declares that she has no competing interests.

Michael Rothberg, MD, MPH

Professor

Center for Value-Based Care Research

Medicine Institute

Cleveland Clinic

Cleveland

OH

Disclosures

MR declares that he has no competing interests.

Acknowledgements

Dr Phuc Le and Dr Michael Rothberg would like to gratefully acknowledge Dr Kenneth J. Smith and Dr Linda Kalilani, the previous contributors to this topic.

Disclosures

KJS and LK declare that they have no competing interests.

Peer reviewers

Julius Atashili, MD, MPH

Department of Epidemiology

Division of General Medicine and Epidemiology

UNC at Chapel Hill

Chapel Hill

NC

Disclosures

JA declares that he has no competing interests.

Ken Mutton, MB, BS, FRCPA, FRCPath

Consultant Virologist

Manchester Royal Infirmary

Manchester

UK

Disclosures

KM declares that he has no competing interests.

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