Text/Reporter Xu Naiyi
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 no improvement. 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 after seeing the doctor, and recovered after 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. Lin Weiyi pointed out that from the perspective of 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 can mainly reduce the occurrence of complications. For example, herpes zoster that occurs on the head, neck, and face may invade the central nervous system, causing some serious sequelae, such as myelitis, meningitis, or encephalitis; herpes zoster on the trigeminal nerve may invade Eyes, causing damage to the cornea, optic neuritis or iritis, thereby affecting vision. Timely administration of medication is an important key to combating herpes zoster.
When the patient has neuralgia, but before the rash appears, sometimes it is not easy to judge it as herpes zoster. Lin Weiyi pointed out that sometimes the rash is only a little bit and not very obvious. In some cases, it even grows on the scalp, and the patient may not realize it. If there is a reminder, the vigilance will be relatively high. Once a rash appears, antiviral drugs will be given as soon as possible. This is also the current treatment concept and direction.
Prevention is better than cure
In the face of herpes zoster, the important principle of “prevention is better than cure” is still inseparable.
1. Immunocompromised patients over the age of 50, diabetes, chronic liver and kidney disease, etc. belong to the high-risk group of herpes zoster, and it is recommended to be vaccinated.
2. Control chronic diseases and blood sugar well, even if you get infected, you will be less likely to have serious and secondary bacterial infections.
3. 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.
Lin Weiyi reminded that if the herpes zoster has a large area, the patient should pay special attention to the care of the wound. Once the wound blisters or ruptures, bacteria may wait for an opportunity to move and cause wound infection. Especially the elderly, patients with diabetes, chronic kidney disease, and liver cirrhosis, whose immune system is relatively fragile. If they suffer from herpes zoster at this time, it may be more serious, and they are prone to concurrent bacterial infections. Special attention should be paid . ◇
