Janine Lourens

1
Shingles

• Mr. Daniel S
• DOB 09/09/1957

2
CHIEF COMPLAINT

• Mr. S is a 47 year old male presenting with a
  rash of small blisters on his skin on the left
  side of the body

3

• Present History
• Burning, shooting pain and itching located on one
  side of the body for several days
• Blisters now appearing along a dermatome

• Past Medical History
• Hypercholesteremia
• Type 2 Diabetes
• s/p Cholecystectomy 2001
• Chicken pox and Measles as child

4
Medications

• NKDA
• Lipitor
• Amaryl
• Aspirin

5
Family History

• Father has history of heart disease and had
  quadruple CABG surgery in 1999
• Mother died of complications from diabetes in
  1990
• Grandmother died from a brain tumor

6
Social History

• Mr. S is a social worker who lives with his wife
  and two sons.
• He does not smoke and drinks alcohol occasionally
  with dinner.
• He does not exercise regularly

7
Physical Exam and Vital Signs

• BP 112/79
• Temperature 98.9F
• Pulse 80
• Red blistery rash correlating with T6 dermatome
• Rest of physical exam unremarkable

8
Lab Values
9
Varicella-Zoster Virus

• Shingles is caused by the same virus as Chicken
  Pox
• Virus lies dormant in nerve cells

10
Treatment Plan and Prognosis

• Rash should disappear in 3-5 weeks
• Could Result in postherpetic neuralgia
• Therefore, treat with Acyclovir (anti-viral)