TEACHING BANGSAL

HERPES ZOOSTER
Group Members
Akbar Kapita Baharsyah
La Ode Muh. Akhiruddin
La Ode Muh. Mukhlisin
Elys Dariatmo Herik
Fahri Dwi Permana
Muh. Samil Genda
Fitri Irmayanti
Dewi Lasimpara
Dewi W Supangat
Ubudiah Nourmala R
Rizky Fauzillah
Nur Aisyah
Andi Nur Fadhilah A

Patients Identity
Name : Syarifah Halwiah
Gender : Female
Age : 51
th
years old
Marital Status : Married
Religion : Moeslem
Address : Kalukue
Occupation : Private sector employees
Registered : 07
th
april 2014

Present Status
General condition : Severe
Consciousness : Coma
Vital sign
BP : 120/75 mmHg
Pulse : 88x/minute,
reguler
Breathing : 20x/minute
Temperature : 36,8
0
C

History Taking
Anamnesis : Alloanamnesis
Chief complaint : Watery vesicel on the right
abdomen region
Further Anamnesis : knew by family about 4
th

day lasthing (3/04/2014) with
fever history about +/- 3th day
lasthing. Looking diameters size
+/- 1 cm and grouping. Originally
watery vesicel looked colored
transparent and day to day
become brown
Dermatology Status
Location : Regio abdomen
dextra (at thoracal
11
th
and 12
th
)

Efflorescence : Group of bulla with
eritema based

Examination Findings
Routine Blood Test
HB: 3,64 10
6
/mm
3

RBC: 10,5 g/dL

WBC: 12,5 10
3

HCT : 51
Kidney Function Test:
Ureum :. mg/dl
Kreatinin: .. mg/dl
SGOT
SGPT
GDS

Diagnosis
Herpes Zooster
Management
PK compres 1 : 10.000 (at morning and
afternon)
MBO
Acyclovir 5x400 mg
DEFINITON
Herpes zooster is a painful skin rash. It is
caused by varicella zoster virus, the same virus
that causes chickenpox.
Anyone who has had chickenpox or received
chickenpox vaccine in the past may develop
shingles.
The risk of getting the disease increases as you
get older
EPIDEMIOLOGY
Herpes Zoster occurs throughout the year
without seasonal prevalence. The Occurrence
of herpes zoster is independent of the
prevalence of varicella, and there is no
convincing evidence that herpes zoster can be
acquired by contact with other person.
The incidence is determined by factors that
influence the host-virus relationship.
Etiologi
Herpes zoster is caused by the varicella zoster
virus (VZV), the same virus that causes
chickenpox
After a person recovers from chickenpox, the
virus stays dormant (inactive)
The virus can reactivate years later.
Patofisiology
During the course of varicella, VZV passes
from lesions in the skin and mucosal surfaces
into sensory nerves to the sensory ganglia.
In the ganglia the virus establishes a latent
infection that persist for life.
Reactivation is sporadic and infrequent
The mechanism involved in reactivation of
latent VZV are unclear but associated with
immunosuppression, ect.
When VZV specific cellular immunity falls
below some critical level, reactivarted virus
can no longer be contained
Virus multiplies and spred within the ganglion
a process that is often accompanied by
severe neuralgia.
Clinical Manifestation
Painful Rash that develops on one side of the
face or body (Unilateral)
Pain, itching, or tingling often develops before
the rash
Other symproms : Fever, Headache, Chills,
Upset Stomach

Laboratory
Routine Blood
VZV serologic assays Collecting and shipping
blood
VZV PCR (polymerase chain reaction)
Histopathology
Differential Diagnosis
1. Varicella
- Varicella is a very contagious disease caused
by the varicella-zoster virus (VZV) it caused a
blister- like rash, itching, tiredness, and fever.

- Varicella can be serious, especially in babies,
adults, and people with weakened immune
systems
Treatment
Antiviral agents: The nucleoside analogues
acyclovir, famciclovir, valacyclovir, and
brivudin

Antiviral Treatment of Varicella in the Normal and
Immunocompromised Host
Topical Therapy
Aplication of cool compresses, calamine lotion,
cornstarch help to alleviate local symptoms and
hasten drying of vesicular lessions.
For Immunocompromise Patiens
Anti- Inflammatory Therapy
Analgesics
Topical
Oral Agents
Prognosis
Herpes zoster usually clears in 2 to 3 weeks
rarely returns.
If the virus affects the nerves the control
movement (the motor nerve), you may have
temporary or permanent weakness or
paralysis