From the Research
No, herpes zoster (shingles) does not typically appear as an upper respiratory infection. Herpes zoster is caused by the reactivation of the varicella-zoster virus and primarily manifests as a painful, blistering skin rash that follows a specific nerve pathway (dermatome) 1. The classic presentation includes a prodromal phase with pain, burning, or tingling in the affected area, followed by the development of fluid-filled vesicles on a red base. While herpes zoster can affect nerves in various parts of the body, including the face and neck, it does not cause typical upper respiratory symptoms like cough, congestion, or sore throat. In rare cases, if herpes zoster affects the cranial nerves, it might cause symptoms in the mouth, ear, or eye, but these would still be distinguishable from a typical upper respiratory infection by the characteristic unilateral distribution and vesicular rash.
Some key points to consider in the diagnosis and treatment of herpes zoster include:
- The importance of early treatment with antiviral medications to reduce pain and accelerate healing 2, 3, 4, 5
- The use of valacyclovir, acyclovir, or famciclovir as first-line treatments for herpes zoster 2, 3, 4, 5
- The potential for postherpetic neuralgia, a complication of herpes zoster that can cause persistent pain 1, 4, 5
- The availability of a recombinant zoster vaccine, which can reduce the incidence of herpes zoster by more than 90% 1
In terms of treatment, valacyclovir (1000 mg three times daily) or famciclovir (500 mg three times daily) for 7 days are effective options, and should be started within 72 hours of rash onset to reduce pain and accelerate healing 2, 3, 4, 5. Acyclovir (800 mg five times daily) is also an effective treatment, but may require more frequent dosing 2, 4.