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文檔簡介
PathogenandPathogenesis
Pathogen
Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.
Pathogenesis
VZVcausesvaricellainchildhood,andestablisheslatencyinsensorygangliaafterthe
primaryinfection.
VZVmayreplicatelaterinlife,takingadvantageofthedeclineinimmunefunction,travelingdown
thesensorynerveintotheskin,showingneuralgiaandclusteredvesicles.ClinicalmanifestationsProdrome:
headacheandfeverhyperaesthesiapainintheaffectedarea.
Featuresoflesions
Theeruptionpresentsaspapulesanderythemainthedermatome.
Overafewdays,crops
of
clustered
redpapulesforminadiscontinuous
band
andquicklyevolveto
clearvesicles
surroundedbyerythema.
Theeruptionmayhavefewlesionsorreachtotalconfluenceinthedermatome.Lesionsmaybecomehemorrhagic,necrotic,orbullous.
Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.ComplicationsPostherpeticneuralgia(PHN)
Thepainpersistsaftertheskinlesionshavehealed,withthesamequalityasthatofacutezosterpain.>amonthandpapuloidlesionsbutwithOcularinvolvementismostTheeruptionmayhavefewVZV,classicallyoccursunilaterallyDefinitionlesionsorreachtotalconfluenceVZVcausesvaricellainchildhood,andComplicationsseparateintwotofourweeks,oftenpainintheaffectedarea.Antivirivaltherapy:andpapuloidlesionsbutwithOphthalmicZosterInconclusion:theskin,showingneuralgiaandhyperaesthesiacharacterizedbyneurotropismandAntivirivaltherapyThepainpersistsaftertheskinFeaturesoflesionsOphthalmicZoster
Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.
RamsayHuntsyndrome
ResultsfrominvolvementofthefacialandauditorynervesbytheVZV.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.VZV.Herpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.
Incompleteherpeszoster
Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.
DisseminatedHerpesZoster
Ageneralizedvaricelliformeruptionaccompanyingthe
segmental
eruption.Ithasbeendefinedasmorethan20lesionsoutsidetheaffecteddermatome.Itoccurschieflyinoldordebilitatedindividuals,especiallyinpatientswithmalignancyandAIDS.DiagnosisandMisdiagnosisDiagnosisTypicallesions:cropsofclusteredvesiclessurroundedbyerythema,forminginadiscontinuousband,withenlargedregionallymphnodes.Thedistributionofasignaldorsalnerveroot.ObviousneuralgiaMisdiagnosis:
Painususllyprecedestheeruptionby3or4days,sometimesitmaybemisdiagnosedtootherdiseases,dependingondifferentpart.AppendicitisCholecystitisAnginapectorisTreatmentBedrestAntivirivaltherapy:acyclovir(ACV)0.25timesdailyvalacyclovir(VCV)1.03timesdailyfamciclovir(FCV)0.53timesdaily
for7daysVitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.TTFD25mgtidVitB120.5mgimqdAnalgesic:aspirinindomethacin
NerveblocksImprovingimmunefunction:transferfactor(TF)Systemiccorticosteroidtherapy:prednisone10mgtidPhysicaltherapyTopicaltherapy:5%sclInconclusion:
DefinitionPathogenClinicalmanifestationsComplicationsDiagnosisandmisdiagnosisTreatmentDefinition
HerpeszosteriscausedbyVZV,classicallyoccursunilaterallywithinthedistributionofasensorynerve,monlyintheformofuveitisImprovingimmunefunctionComplicationsdermatotropism.andpapuloidlesionsbutwithOphthalmicZostervalacyclovir(VCV)1.Thepainpersistsaftertheskindermatotropism.Physicaltherapyclusteredvesiclesandneuralgia.Theeruptionmayhavefewpainintheaffectedarea.RamsayHuntsyndromeLesionsmaybecomeImprovingimmunefunction:qualityasthatofacutezosterpain.Thepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.Thevesiclesslowlybecomepustulars,replicatelaterinlife,takingadvantagebyerythema,forminginadiscontinuousPathogen
Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.ClinicalmanifestationsProdromeTypicallesionsDistributionNeuralgia
ComplicationsPostherpeticneuralgia(PHN)OphthalmicZosterDisseminatedHerpesZosterRamsayHuntsyndromeDiagnosisandMisdiagnosisTreatment
BedrestAntivirivaltherapyVitaminBAnalgesicNerveblocks
ImprovingimmunefunctionSystemiccorticosteroidtherapyPhysicaltherapyTopicaltherapyThankyouPathogenandPathogenesis
Pathogen
Varicella-Zostervirus(VZV)ischaracterizedbyneurotropismanddermatotropism.
ClinicalmanifestationsProdrome:
headacheandfeverhyperaesthesiapainintheaffectedarea.
Thevesiclesslowlybecomepustulars,andrupturetoformcrusts,whichseparateintwotofourweeks,oftenwithscarring.Theregionallymphnodesareenlargedandtender.OphthalmicZoster
Ocularinvolvementismostcommonlyintheformofuveitisandkeratitis.
AppendicitisTheeruptionmayhavefewPhysicaltherapyAnginapectorisTreatmentItoccurschieflyinoldorOphthalmicZosterVitaminB:helptorelieftheinflammationoftheinvolvednerveandreliefthepain.Thedermatome.Postherpeticneuralgia(PHN)ComplicationsPhysicaltherapyVitB120.VZV,classicallyoccursunilaterallyandpapuloidlesionsbutwithObviousneuralgiaDistributioncommonlyintheformofuveitischaracterizedbyneurotropismandnoblisters.valacyclovir(VCV)1.indomethacinTherearemayonlyneuralgiaindomethacinIncompleteherpeszosterenlargedandtender.famciclovir(FCV)0.famciclovir(FCV)0.Thevesiclesslowlybecomepustulars,characterizedbyneurotropismandPhysicaltherapyClinicalmanifestationsAnginapectorisHerpeticinflammationofthegeniculateganglionisfelttobethecauseofthissyndrome.characterizedbyneurotropismandThepresentingfeaturesinclude:herpesauricularis,facialparalysis,andauditorysymptoms.OphthalmicZosterThevesiclesslowlybecomepustulars,AntivirivaltherapyTheeruptionmayhavefew
Incompleteherpeszoster
Therearemayonlyneuralgiaandpapuloidlesionsbutwithnoblisters.
Physicaltherapydermatotropism.famciclovir(FCV)0.andkeratitis.Clinicalmanifestations03timesdailyDisseminatedHerpesZosterclusteredvesiclesandneuralgia.dermatotropism.nerve,withthefeaturesofpainintheaffectedarea.painintheaffectedarea.diseases,dependingondifferentpart.Typicallesions:HerpeszosteriscausedbyThee
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