Clinical Reference Systems: Pediatric Advisor 10.0
Shingles (Zoster)
SYMPTOMS AND CHARACTERISTICS
- A linear rash that follows the path of a nerve.
- The rash occurs on only one side of the body.
- The rash starts with clusters or red bumps, changes to
water blisters, and finally becomes dry crusts (looks
like small groups of chickenpox sores).
- The back, chest, and abdomen are the most common sites.
- The rash usually doesn't burn or itch in children (in
contrast to the adult form).
- Your child does not have a fever or feel sick.
- Your child had chickenpox in the past.
CAUSE
Shingles (zoster) is caused by the chickenpox virus. The
disease is not caught from other people who have shingles or
chickenpox. The chickenpox virus lies dormant in the bodies
of some people and is reactivated for unknown reasons as
zoster. Children with zoster are usually over age 3 years.
EXPECTED COURSE
New rashes continue to appear for several days. All the
rash dries up by 7 to 10 days. Complications do not occur
unless the shingles affect the eyes. If zoster involves the
nose, the cornea is usually also affected. Most people have
shingles just once; a second attack occurs in 5% of children
who get zoster.
HOME CARE
- Relief of symptoms
Most children have the rash but no symptoms. For pain,
give acetaminophen or ibuprofen as needed. Avoid giving
aspirin for zoster because of the possible link of
aspirin and viral infections with Reye's syndrome.
Discourage scratching or picking the rash. The rash
does not need any cream.
- Contagiousness
Children with zoster can transmit chickenpox (but not
zoster) to others. Transmission occurs by touching the
zoster rash. Although they are far less contagious than
children with chickenpox, children with zoster should
stay home from school for 7 days unless they can keep
the rash covered until it crusts over. Children or
adults who have not had chickenpox should avoid visiting
a child with zoster (unless the rash is covered).
CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:
- The zoster rash involves the eye or nose.
CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:
- The rash becomes very painful or very itchy.
- The rash lasts more than 14 days.
- The rash looks infected (pus or soft yellow scabs).
- You have other questions or concerns.
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