From the Research
Fever is a common symptom in shingles, occurring in approximately 31.1% of patients, as reported in the most relevant study 1. When present, the fever typically develops during the early stages of the infection, often appearing alongside or shortly after the characteristic rash. The fever is usually low-grade (under 101°F or 38.3°C) and may be accompanied by other systemic symptoms like fatigue, headache, and general malaise. For fever management in shingles, acetaminophen (Tylenol) at a dose of 650mg every 6 hours (not exceeding 3000mg daily) is typically recommended. Ibuprofen (Advil, Motrin) at 400-600mg every 6-8 hours with food can also be effective. The fever associated with shingles is caused by the body's immune response to the reactivation of the varicella-zoster virus, which had remained dormant in nerve tissues since the initial chickenpox infection. While fever itself is not dangerous in most cases, persistent high fever (above 102°F or 38.9°C) or fever lasting more than 3-4 days should prompt medical attention as it may indicate complications or secondary infection.
Some key points to consider in the management of shingles and its associated fever include:
- Early treatment with antiviral medications can help reduce the severity and duration of symptoms, including fever 2, 3, 4.
- The varicella-zoster virus vaccine can help prevent shingles and its complications, including fever, in adults 50 years and older 3.
- Postherpetic neuralgia, a common complication of shingles, can be managed with medications such as gabapentin, pregabalin, or tricyclic antidepressants 3.
- It is essential to monitor patients with shingles for signs of complications, such as bacterial superinfection, and to provide prompt treatment if necessary 1.
In terms of the incidence of fever in shingles, the study by 1 reported a frequency of 31.1%, which is higher than the estimated 20-25% reported in other studies. However, this study provides the most recent and relevant data on the clinical manifestations of herpes zoster, including fever. Therefore, the incidence of fever in shingles is approximately 31.1%, and it is essential to manage it promptly to prevent complications and improve patient outcomes.