[Reporter Peng Huiwan/Taoyuan Report]When a patient has neuralgia but before the rash appears, sometimes it is not easy to determine that it is herpes zoster. A 58-year-old man in Taoyuan suffered from pain in his temples, forehead, and even extended to the scalp, which lasted for a whole day and was unbearable. After going to the clinic and taking painkillers, there was still no improvement, so he went to Lianxin International Hospital for treatment . Lin Weiyi, Director of the Department of Neurology, said that judging from the patient’s main statement and symptoms, it was judged to be suffering from herpes zoster. The patient also developed a rash 5 days following seeing the doctor, and recovered following being given antiviral drugs and recuperating.
The patient only reported that he had an unbearable headache when he went to the doctor, and he had never had such a pain. After detailed examination of the location and condition of the pain, it was determined that he had herpes zoster. Director Lin Weiyi pointed out that judging from the pain pattern of this patient, it looks like acupuncture or knife cutting, and the range is distributed along a single nerve, which is more in line with the characteristics of neuralgia, rather than soreness caused by muscle inflammation or fatigue. Pain levels vary widely. He further pointed out that neuralgia should be suspected if the range of pain matches the distribution of a ganglion or nerve. We will remind patients that once a rash occurs, they should seek medical attention as soon as possible and take antiviral drugs for shingles.
Lin Weiyi said that giving antiviral drugs is mainly to reduce the occurrence of complications, such as herpes zoster that occurs on the head, neck and face, which may invade the central nervous system and cause some serious sequelae, such as spondylitis and meningitis Or encephalitis, etc. Herpes zoster in the trigeminal nerve may invade the eyes, causing corneal damage, optic neuritis or iritis, and then affecting vision. Therefore, immediate drug administration is an important key to fighting herpes zoster.
Director Lin pointed out that sometimes it is not easy to judge herpes zoster. Sometimes the rash is only a little bit, not very obvious, and in some cases it even grows on the scalp. The patient may not be aware of it. If there is a reminder, the alertness will be relatively high. Once the rash appears, antiviral drugs will be given as soon as possible. It is also the current treatment concept and direction.
In the face of herpes zoster still cannot escape the important principle of “prevention is better than cure”, Director Lin Weiyi said that patients with low immunity such as over 50 years old, diabetes, chronic liver and kidney disease belong to the high-risk group of herpes zoster, and it is recommended to get shingles vaccine. The second is to control chronic diseases and blood sugar well, so that even if you get infected, you will not be complicated by serious and secondary bacterial infections. Furthermore, you must start by strengthening your own immunity, such as eating a balanced diet and developing exercise habits. Once you have shingles, seek medical attention as soon as possible and take antiviral drugs to reduce the risk of other complications.
Dr. Lin also reminded that if the area of herpes zoster is large, the patient should pay special attention to the care of the wound. Once the wound blisters and ruptures, bacteria may wait for an opportunity to cause wound infection, especially the elderly, diabetes, Patients with chronic kidney disease and liver cirrhosis have relatively fragile immune systems. If they suffer from herpes zoster at this time, it may be more serious and they are prone to concurrent bacterial infections, so special attention must be paid.
Photo: Director Lin Weiyi reminded patients with herpes zoster to pay special attention to wound care. (Photo: Photo by reporter Peng Huiwan)
