Hows Shingles Without A Rash Diagnosed
Shingles without a rash isnt common, but it may be more common than previously thought because it often goes undiagnosed. Shingles without a rash is difficult to diagnose based on your symptoms alone.
Your doctor may test your blood, cerebrospinal fluid, or saliva to identify the presence of VZV antibodies. This will allow them to confirm a diagnosis of shingles without a rash. However, these tests are often inconclusive.
Your medical history may provide clues that suggest you have shingles without a rash. Your doctor may ask if youve had a recent operation or if youre under increased stress.
Once your doctor suspects you have VZV, theyll use antiviral medicines such as acyclovir to treat the shingles. They may also prescribe drugs for the pain.
Other treatment will vary based on the location and severity of symptoms.
Who Should Not Be Vaccinated With Shingrix
You shouldnt receive the Shingrix vaccine if you:
- Have ever had a severe allergy to this vaccine or any ingredient in this vaccine.
- Are breastfeeding or pregnant.
- Currently have shingles.
- Are ill and have a high fever.
- Have tested negative for immunity to varicella-zoster virus .
Ask your healthcare provider if the benefits of getting the vaccine outweigh any potential risks.
Development Of Medical Testing
A number of advances introduced mostly in the 19th century, allowed for more objective assessment by the physician in search of a diagnosis, and less need of input from the patient. During the 20th century the introduction of a wide range of imaging techniques have made a huge impact on diagnostic capability. Other developments in the field of genetics, medical biochemistry, and molecular diagnostics have also played major roles.
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Who Should Be Vaccinated With Shingrix
The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.
You should get the Shingrix vaccine even if:
- Youve had shingles already.
- Youve been previously vaccinated with Zostavax . If youve been vaccinated with Zostavax, wait at least eight weeks before getting vaccinated with Shingrix.
- You dont know for sure if youve ever had chickenpox.
Ask your healthcare provider, who knows your entire health history if getting this vaccine is right for you.
In Cases Of Weakened Immunity
In people with HIV and other immunological disorders, both chickenpox and shingles can take longer to clear, up to four weeks in some cases. Whats more, shingles can recur in such people.
Treatment of shingles can include the antiviral drugs valacyclovir or famciclovir. These drugs can speed the healing of lesions and sometimes cause a reduction in pain and the risk for post-herpetic neuralgia.
Although vaccines are licensed to reduce the risk of developing chickenpox and shingles, they contain weakened but live virus. People with HIV infection should consult an infectious disease or HIV specialist about whether it is safe for them to receive these vaccines. If someone with a weak immune system is in contact with a person infected with chickenpox, it is important that they contact their health care provider to find out if they need treatment to prevent developing chickenpox themselves.
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Hiv/aids And Molluscum Contagiosum
Molluscum contagiosum is an infection that is marked by smooth white or flesh-colored bumps on the skin. It is caused by a virus and is contagious.
This condition is not serious, and the bumps often resolve on their own without treatment. However, in people with HIV infection whose immune systems are functioning poorly, the infection can become very chronic and progressive. If necessary, the bumps can be removed by a doctor by scraping or freezing. Drug treatments may include retinoic acid or imiquimod cream. Again, the best treatment is to treat the HIV itself, and as the immune system improves, the molluscum will resolve.
Kaposi’s Sarcoma And Hiv/aids
KS appears as purplish or dark lesions on the skin. Because of the weakened immune system caused by AIDS, KS can spread quickly to other parts of the body, including internal organs.
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Can You Get Shingles From The Covid
There have been a few reports of shingles happening in people who were vaccinated against COVID-19. The varicella-zoster virus was reactivated in these people.
A note from Cleveland Clinic
If youve had chickenpox, youre at risk of developing shingles later in life. Shingles causes a rash that is contagious and painful. The disease can have serious complications. The best thing you can do to reduce your risk is to get the shingles vaccine. The vaccines are safe and effective.
Hiv Rashes Caused By Medication
Drugs that treat HIV and related infections can trigger rashes. These often go away several days or weeks after you stop taking the drug. Talk with your doctor before stopping any medication.
If you have a rash along with fever, fatigue, headache, muscle pains, upset stomach, vomiting, and belly pain, you might have a âhypersensitivity reaction,â which can happen with several HIV medications, including:
Get medical help right away if you have those symptoms or if you have:
- Painful red or purplish rash
- Blisters that spread on your skin and around your mouth, nose, and eyes
These could be signs of Stevens-Johnson syndrome, a severe form of hypersensitivity reaction. Itâs rare but can be life-threatening.
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When Should You Call Your Doctor
- Have a rash or blisters on your face, especially near an eye or on the tip of your nose. This can be a warning of eye problems. Treatment can help prevent permanent eye damage.
- Think you have shingles. Early treatment with antiviral medicines may help reduce pain and prevent complications of shingles, such as disseminated zoster or post-herpetic neuralgia.
If you still feel intense pain for more than 1 month after the skin heals, see your doctor to find out if you have post-herpetic neuralgia . Getting your pain under control right away may prevent nerve damage that may cause pain that lasts for months or years.
Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later
After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.
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Oral Hairy Leukoplakia As A Sign Of Hiv/aids
Oral hairy leukoplakia is an infection that appears in the mouth as white lesions on the bottom or sides of the tongue. Oral hairy leukoplakia may be one of the first signs of HIV/AIDS. The infection is caused by the Epstein-Barr virus.
Oral hairy leukoplakia lesions may be flat and smooth or raised and furry . The lesions do not cause pain or discomfort, so they are usually not treated. The condition resolves on its own, but can recur often. If necessary, oral hairy leukoplakia can be treated with acyclovir, a medication that treats herpes .
Immune Reconstitution Inflammatory Syndrome
At times, shingles flares up after people with HIV start treatment. This is due to a mechanism called immune reconstitution inflammatory syndrome, or IRIS. IRIS is a state of a hyperinflammatory response, a complication as a result of antiretroviral therapy , and usually happens within the first six months of treatment.
If someone develops shingles shortly after beginning treatment for HIV, this may show that the immune system is responding to treatment by targeting specific viruses and bacteria in the body. This is known as immune restoration syndrome. If you suspect shingles after starting ART, talk to your doctor immediately to lower your chances of developing shingles-related complications.
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Why Does Shingles Appear Mostly On One Side Or In One Area Of Your Body
The virus travels in specific nerves, so you will often see shingles occur in a band on one side of your body. This band corresponds to the area where the nerve transmits signals. The shingles rash stays somewhat localized to an area. It doesnt spread over your whole body. Your torso is a common area, as is your face.
What Can I Do If I Have An Attack Of Shingles
Shingles can be a painful and very uncomfortable condition, but there are a number of things you can do to make yourself more comfortable. These include:
- Taking paracetamol for the pain
- Applying a cold compress to affected areas
- Keeping the rash clean and dry to reduce infection
- Avoiding antibiotic cream.
If you think you are experiencing symptoms of shingles, the best thing to do is to go and see your doctor. It is important to get shingles diagnosed as soon as possible, as early treatment with antiviral medicine can help lessen an attack, but this needs to be taken within the first few days of any visible symptoms.
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What If A Person Has Never Had Chickenpox Or The Vaccine For It
Shingles doesnt spread from one person to another. And those whove never had chickenpox or received the chickenpox vaccine cant get shingles.
The varicella-zoster virus that causes shingles can be transmitted, however. Those who dont have the virus can contract it from exposure to active shingles blisters, and then develop chickenpox as a result.
Following are a few precautions to take to reduce risk of contracting the varicella-zoster virus:
- Try to avoid exposure to people with chickenpox or shingles.
- Be especially careful to avoid direct contact with the rash.
- Ask a healthcare professional about getting the vaccine.
There are two shingles vaccines available. The newest vaccine contains inactivated virus, which wont cause a shingles infection and so can be given to people whose immune system is severely compromised. The older vaccine contains the live virus and may not be safe in this case.
Consult a healthcare professional to find out if they recommend getting vaccinated against shingles.
Those with HIV might get a more severe case of shingles and are also at increased risk of complications.
Can You Get Shingles If You Havent Had Chickenpox
No. You cant get shingles if youve never had chickenpox, but you can get chickenpox from someone who has shingles. If youve never had chickenpox and you come into direct contact with the oozing, blister-like rash of someone with shingles, the varicella-zoster virus can infect you and you would develop chickenpox.
Once youve had chickenpox, you could develop shingles at some point in your life. This is because the varicella-zoster virus never fully goes away after youve had chickenpox. It lies quietly inactive in your nerve tissue. Later in life, the virus may become active again and appears as shingles.
Can you get chickenpox more than once?
Its rare to get chickenpox twice in your life. Once youve had chickenpox, youre usually immune to it for the rest of your life. However, its not totally impossible. If you have a severely weakened immune system , you can get chickenpox a second time. If youve had chickenpox, you are more likely to get shingles at some point in your life than a repeat bout of chickenpox.
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Treatment If The Condition Gets Worse
In some cases, shingles causes long-term complications. Treatment depends on the specific complication.
- Post-herpetic neuralgia is persistent pain that lasts months or even years after the shingles rash heals. Certain medicines, such as anticonvulsants, antidepressants, and opioids, can relieve pain. Most cases of PHN resolve within a year.
- Disseminated zoster is a blistery rash over a large portion of the body. It may affect the heart, lungs, liver, pancreas, joints, and intestinal tract. Treatment may include both antiviral medicines to prevent the virus from multiplying and antibiotics to stop infection.
- Herpes zoster ophthalmicus is a rash on the forehead, cheek, nose, and around one eye, which could threaten your sight. You should seek prompt treatment from an ophthalmologist for this condition. Treatment may include rest, cool compresses, and antiviral medicines.
- If the shingles virus affects the nerves originating in the brain , serious complications involving the face, eyes, nose, and brain can occur. Treatment depends on the nature and location of the complication.
Complications Of Having Both Shingles And Hiv
HIV and other chronic conditions that weaken the immune system can cause shingles symptoms and complications to become more severe.
When a person has both HIV and shingles, they are more likely to experience the following complications of shingles:
- long-term pain, which can last for months or years
- longer-lasting shingles symptoms
- a higher risk of skin infections
- a higher risk of developing chronic shingles
- disseminated zoster, in which the rash covers a much larger part of the body
- Blank, L. J., Polydefkis, M. J., Moore, R. D., & Gebo, K. A. . Herpes zoster among persons living with HIV in the current ART era. Journal of Acquired Immune Deficiency Syndrome, 61, 203â207
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How Is Shingles Treated
Shingles is treated with medicines. These medicines include antiviral medicines and medicines for pain.
See your doctor right away if you think you may have shingles. Starting antiviral medicine right away can help your rash heal faster and be less painful. And you may need prescription pain medicine if your case of shingles is very painful.
Good home care also can help you feel better faster. Take care of any skin sores, and keep them clean. Take your medicines as directed. If you are bothered by pain, tell your doctor. Other treatments may help with intense pain.
Do You Always Get The Typical Rash If You Have Shingles
Occasionally, some people dont get a rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments you can take early for shingles. Even if you dont have shingles, seeing your healthcare provider will help you get your condition diagnosed and treated.
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When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
What Is The Connection To Hiv
People with HIV have been found to have higher rates of shingles than the general population. They are also at risk of experiencing complications as a result of shingles.
HIV targets the immune system by depleting it of its CD4 T lymphocytes . CD4 cells are lymphocytes, a type of white blood cell that helps the body fight off infections.
While shingles can be triggered in adults with HIV at any CD4 count, the risk of infection is higher in people with lowered CD4 counts, as in less that 200 cells per cubic millimeter of blood . Lowered CD4 counts are linked to untreated HIV and stage 3, or advanced, HIV. This is why shingles may indicate HIV since untreated HIV and stage 3 HIV are associated with a higher chance of developing shingles.
A person with a compromised immune system is more susceptible to getting shingles. This includes people with untreated HIV and stage 3 HIV. This may have to do with depleted levels of CD4 cells, meaning the body is more vulnerable to infection.
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Sudden Unexplained Weight Loss
National Human Genome Research Institute
Weight loss is common in people living with HIV during the advanced stages of the disease.
The condition is also called HIV wasting syndrome. It’s not as common today as it once was because antiretroviral drugs keep the virus suppressed and allow the immune system to rebuild itself. Wasting is mainly seen in people who have not been treated for HIV.
The exact cause of HIV wasting is unknown, but it is thought that the constant inflammation caused by HIV makes the body burn energy faster and reduces testosterone levels .
Many People Have No Symptoms But Watch For These
Unexplained rash, swollen lymph nodes, oral thrush, night sweats, and sudden and unexplained weight loss are all possible signs of HIV. Having a sexually transmitted infection isn’t a physical sign of HIV, but it does indicate a greater risk of having HIV as well.
The signs or symptoms of human immunodeficiency virus are not always obvious, though. And in fact, most people who have HIV do not exhibit any of them. Signs of HIV can also depend on whether a person is in the new or persistent stage of infection.
Only an HIV test can tell you for sure if you have the virus. Still, it is important to know about these six common signs and symptoms of HIV, especially if you are someone who is considered to be at higher risk for infection. This article explains each of them.
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U.S. National Library of Medicine / National Institutes of Health
A rash is often the first sign of HIV, but it only appears in 2 of every 5 newly infected people.
An HIV rash looks a certain way: large areas of flat, reddened skin peppered with tiny bumps.
The rash can be itchy or painful. Once a person gets the rash, flu-like symptoms are also common.
The HIV rash usually starts two to six weeks after exposure to the virus and will go away within one to two weeks. The rash is widespread and mainly affects the trunk and face, but can also be on the arms, legs, hands, and feet.
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