this pt has herpes viral infection plz advise for treatment and investigations@Dr. Rini Thakur

10 Likes

LikeAnswersShare

Erythematous skin lesions with Mculopapular, Vesicles, Pastules, lesions in da distribution of da Trigeminal Nerve, Vesicles on da nose(Hutchinson's sign), Which is a strong predictor of Occular Involvement, by HZV--- It's a case of: - HERPES ZOSTER OPTHALMICUS(HZO). - DIAGNOSIS: - SLIT-LAMP BIOMICROSCOPY MUST B NEEDED. - CORNEA SCRAPING of any lesion to B sent for Laboratory test, a Tzanck Smear--- - Alternatively, Culture may B sent for Immunofluorescence Assays to look for IgM specific to VZV--- - Viral Culture N Polymerase Chain Reaction testing may also B helpful--- - RX: - Acyclovir 800mg, Five times/day for 10days or If Pt can't tk food by mouth, Acyclovir 5 - 10mg/kg iv QDS for 5 -7day. - Topically Acyclovir Ophthalmic Ointment 5 times/Day--- - Topical Steroids eg, Prednisone acetate 1%, should B used for interstitial Keratitis or Uveitis, N Depending on Optic neuritis, Retinitis, Systemic/iv Corticosteroid should be given--- - Pain should B treated by Analgesics + Opiods(PCM + Tramadol)--- - Amitriptyline 10 - 25mg P/O QDS + Gabapentin 300 BDS for Neuropathic Pain--- Cabamazepine, Tegretol 200mg BD/TDS is a Very Good Choice for Neuropathic Pain, in HZO--- - Capsaicin Cream topically, may decrease da pain--- -FINALLY, --- PATIENT SHOULD B MONITORED, STRICTLY, DEPENDING ON THE SEVERITY OF OCCULAR FINDINGS--- --- THANKS.

it's really an Executive Case, N I Tried My Best--- Waiting for much more Updates N Correction of My Mistakes--- Thanks @Dr. Mueez Ahmad SIR
3

View 13 other replies

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Herpaticus ophthalmicus vesicular stage Acyclovir skin oint 4to 5 time daily kalamina lotion twice Tab acyclovir 800mg 5 hourly tad promethazinef twice daily tab ibubrufen 600mg twice lubricants 4 to 5 times Acyclovir Eye oint 5 time , good nutritious diet after one week you can prescribe oral dose of acyclovir to400 mg 5 hourly, ibuprofen to 400mg bd and add gaba pentine orally

Herpes zoster ophthalmics : Rx : - topical acyclovir e/oint 5 tines in a day . - Topical tobramycin with dexamethasone . - Topical atropine e/drops. - Topical timolol e/drops. - oral nsaid , acyclovir , cimetidine .

HERPES ZOSTER OPHTHALMICUS, Nicely explained by @Dr. S. Dhara

Typical HERPES ZOSTER OPHTHALMICUS showing vesicles on the tip of the nose and eye is going to be involved called Hutchinson rule . Treatment is nicely summarized by Dr. S.Dhara

Herpes zoster ophthalmic us

Herpies zoster opthalmicus

Load more answers