Help Please .. !!
Yesterday during my Nightshift , a 19 years old girl came, suffering from painful rush du to scratches all over her line of jersey and back .. It looked a little bit like the picture above , but more with black dots spreaded on the scratches... Beside that: - her abdomen was inflated ( palpation == splenomegaly ) - she is hypertensive (9 mmHg, 16 mmHg) and diabetic ( 4.12 g/l ) - abnormal rougeure on the cheeks -the rest of anamnes was normal , no anticidents (I could not have more details, she was not my patient ) My diagnosis was : - shingles disease (the scratches) My interrogation is : -what are the possible links between a splenomegalie and a shingles disease?! (I apologize for the mistakes, English is not my native language as well as I study in French language) (shingles disease = Zona maladie : in French)
Shingles is caused by the Varicella Zoster Virus. An initial infection with chickenpox would introduce the body to the virus, upon resolution of the illness, the virus may remain inactive within nerve cells. Immune suppression, and old age are common risk factors for reactivation. Uncontrolled diabetes can cause increased incidences of infections in patients, and immune deficiency to a certain extent, that being the reason for the reactivation. The virus travels down the nerve body to the peripheral endings in the skin. Considering the close contact pathways between nerves and blood vessels, the virus can spread to the vessels and affect blood circulation. It can cause ischemic necrosis if tissues. In the brain this can cause encephalitis, in the liver , hepatitis, and perhaps secondary to hepatitis or on its own inflammation/enlargement of the spleen.
Thank you Moha ... So we may say that her incontrolled diabetes (which was around the 3 g/l sometimes 4.5 g/l those last 5 days) caused the reactivation of the virus . The appearance of the scratches synchronized the increase of glycemia .
Ma première pensée en voyant la photo: Herpes Zoster/ Zona / Gürtelrose. Comme un ceintre autour du thorax supérieur allant vers le dos ligne du nerv touché très douloureux et contagieux lors les pustules s ouvrent
Oui c est une photo que j'ai télécharger de google , je pouvais pas prendre une photo de la patiente alors qu'elle etait entrain de souffrire
