Infectious Disease

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Bacterial Meningitis

(NF001)

Introduction

The meninges are membranes that enclose the brain and spinal cord. Meningitis is an inflammation of the meninges, the most common cause of which is infection by viruses or bacteria that enter the meninges through the bloodstream from other parts of the body. This area of the body has no "host defenses" to fight off invading bacteria, which allows unchecked duplication of the infecting organism.

Bacterial meningitis causes inflammation and swelling that can result in significant consequences including hearing loss, brain damage, and even death.

Bacteria that cause meningitis are carried in the nose and throat (nasopharynx). People can be "infected" with the bacteria for days, weeks or months with no symptoms. At any given time it is estimated that 10% of the population are "carriers". Aside from epidemics, at least 1.2 million cases of bacterial meningitis are estimated to occur every year with 135,000 of these cases being fatal.

Treatment of bacterial meningitis requires antibiotics as well as medications such as steroids to reduce swelling in the brain. Close contacts of persons with meningitis are usually prescribed antibiotics to prevent further development and spread of the disease.

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The Medifocus Guide on Bacterial Meningitis provides answers to the following important questions and medical issues:

What are the most common symptoms of bacterial meningitis?

Are there any recognized risk factors for developing bacterial meningitis?

What kinds of medical tests are used to establish the diagnosis of bacterial meningitis?

What is the current standard of care for the treatment of bacterial meningitis?

What treatment options are available for the management of bacterial meningitis?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in bacterial meningitis?

Where are the leading hospitals and centers of research for bacterial meningitis?

What are the most important questions to ask my doctor about bacterial meningitis?

What Your Doctor Reads:

This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:

Serious infections of the central nervous system: encephalitis, meningitis, and brain abscess.

Adolescent Medicine. 2000

The management of neurosurgical patients with postoperative bacterial or aseptic meningitis or external ventricular drain-associated ventriculitis. Infection in Neurosurgery Working Party of the British Society for Antimicrobial Chemotherapy.

British Journal of Neurosurgery. 2000

Antibacterial agents in infections of the central nervous system.

Infectious Disease Clinics of North America. 2000

Designing meningitis vaccines.

Journal of the Royal College of Physicians of London. 2000

Imaging of rickettsial, spirochetal, and parasitic infections.

Neuroimaging Clinics of North America. 2000

Meningitis due to Neisseria subflava: case report and review.

Clinical Infectious Diseases. 2000

Tuberculous meningitis.

2000

Update on meningococcal disease with emphasis on pathogenesis and clinical management.

2000

Streptococcus bovis meningitis in an infant.

Journal of Clinical Microbiology. 2000

Group A streptococcal meningitis in the antibiotic era.

1999

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Coccidioidomycosis

(NF005)

Introduction

Coccidioidomycosis is a fungal infection caused by inhalation of the fungus Coccidioides immitis. C. immitis grows as a mold in the soil. When the soil is disturbed, the mold hyphae fragment, forming structures that become airborne. If inhaled by animals or humans, they transform into thick-walled spheres that produce thousands of endospores, which are capable of reproducing. Epidemics of coccidioidomycosis have occurred following large-scale soil disturbances caused by dust storms, earthquakes, and excavations.

In persons with competent immune systems, the majority of infections produce no symptoms or mild, self-limited upper respiratory tract illness. At least two-thirds of coccidioidal infections go unnoticed. Moderate to severe illness involving the lower respiratory tract takes several weeks to develop. Acute infections usually resolve without therapy within a few weeks or months. In 5-10% of persons, however the infection progresses to chronic pulmonary disease or disseminates via the blood or lymph circulation to the skin, bones, meninges, or other sites.

Acute infections usually resolve without therapy within a few weeks or months. However, when the infection progresses to chronic pulmonary disease or disseminates, antibiotic treatment is required.

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The Medifocus Guide on Coccidioidomycosis provides answers to the following important questions and medical issues:

What are the most common symptoms of coccidioidomycosis?

Are there any recognized risk factors for developing coccidioidomycosis?

What kinds of medical tests are used to establish the diagnosis of coccidioidomycosis?

What is the current standard of care for the treatment of coccidioidomycosis?

What treatment options are available for the management of coccidioidomycosis?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in coccidioidomycosis?

Where are the leading hospitals and centers of research for coccidioidomycosis?

What are the most important questions to ask my doctor about coccidioidomycosis?

What Your Doctor Reads:

Hyphal forms in the central nervous system of patients with coccidioidomycosis.

Clinical Infectious Diseases. 2000

Coccidioidomycosis meningitis with massive dural and cerebral venous thrombosis and tissue arthroconidia.

Archives of Pathology & Laboratory Medicine. 2000

Airway coccidioidomycosis--report of cases and review.

Clinical Infectious Diseases. 1999

Coccidioidomycosis--the airborne assault continues: an unusual presentation with a review of the history, epidemiology, and military relevance.

Aviation Space & Environmental Medicine. 1999

Endemic mycoses: a treatment update.

Journal of Antimicrobial Chemotherapy. 1999

Coccidioidomycosis: a regional disease of national importance. Rethinking approaches for control.

Annals of Internal Medicine. 1999

Recent advances in cryptococcosis, candidiasis and coccidioidomycosis complicating HIV infection.

Medical Mycology. 1998

Coccidioidomycosis: an update.

Hospital Practice (Office Edition). 1998

Treatment of coccidioidal spinal infection: experience in 16 cases.

Journal of Spinal Disorders. 1997

Coccidioidomycosis.

Current Clinical Topics in Infectious Diseases. 1997

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Ehrlichiosis

(NF006)

Introduction

Tick-borne illnesses are caused by infection with a variety of disease-causing pathogens, including rickettsia and other types of bacteria, viruses, and protozoa. Because ticks can harbor more than one disease-causing agent, persons can be infected with more than one pathogen at the same time.

While there are several different ticks that carry disease, the one many people are familiar with is Ixodes scapularis, more commonly known as the deer or bear tick in North America. This is the one that causes Lyme disease. Other ticks that transmit B. burgdorferi are the Ixodes dammini and the Ixodes pacificus. Ticks that transmit other diseases include the lone star tick

(A. americanum), the dog tick, wood tick, and the Western Black-legged tick.

Ehrlichiosis is a recently recognized bacterial (rickettsiae) disease that is spread by infected ticks. Two types of human ehrlichiosis have been identified in the U.S.: human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE). The disease attacks different types of white blood cells (either monocytes or granulocytes). Evidence suggests that the lone star tick transmits HME and the deer tick transmits HGE.

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The Medifocus Guide on Ehrlichiosis provides answers to the following important questions and medical issues:

What are the most common symptoms of Ehrlichiosis?

Are there any recognized risk factors for developing Ehrlichiosis?

What kinds of medical tests are used to establish the diagnosis of Ehrlichiosis?

What is the current standard of care for the treatment of Ehrlichiosis?

What treatment options are available for the management of Ehrlichiosis?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in Ehrlichiosis?

Where are the leading hospitals and centers of research for Ehrlichiosis?

What are the most important questions to ask my doctor about Ehrlichiosis?

What Your Doctor Reads:

Annual update of systemic disease--1999: emerging and re-emerging infections (Part II).

Journal of Neuro-Ophthalmology. 2000

Gastrointestinal and hepatic manifestations of human ehrlichiosis: 8 cases and a review of the literature.

Digestive Diseases. 1999

Ehrlichiosis.

Infectious Disease Clinics of North America. 1998

Human granulocytic ehrlichiosis in a renal transplant patient: case report and review of the literature.

Transplantation. 1997

Ehrlichiosis in children.

Journal of Pediatrics. 1997

Is human granulocytic ehrlichiosis a new Lyme disease? Review and comparison of clinical, laboratory, epidemiological, and some biological features.

Clinical Infectious Diseases. 1997

Human ehrlichiosis.

Postgraduate Medicine. 1997

Sequence analysis of the ank gene of granulocytic ehrlichiae.

Journal of Clinical Microbiology. 2000

Human monocytic ehrlichiosis: a potentially severe disease in children.

Archives of Pediatrics & Adolescent Medicine. 2000

Transmission of the agent of human granulocytic ehrlichiosis by Ixodes spinipalpis ticks: evidence of an enzootic cycle of dual infection with Borrelia burgdorferi in Northern Colorado.

Journal of Infectious Diseases. 2000

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Genital Herpes Infections

(NF008)

Introduction

The herpes simplex virus (HSV) is the cause of genital and oral herpes infections. HSV-2 attacks the genital area and is sexually transmitted. The risk of transmission is lower during latency, but some chance always exists that the virus is shedding and transmissible at anytime.

Recurrences of HSV-2 occur in most persons due to the renewed multiplication of the virus. This process can occur weeks, months, or years after the initial outbreak, but tends to be frequent within the first year. It is not fully understood what factors trigger a recurrence. Possibilities include sunlight, fever, local physical injury, menstruation, suppression of the immune system or emotional stress.

It is estimated that at least 45 million Americans are infected with HSV-2 and the rate of infection has been increasing in recent years.

Newborns whose mothers have HSV-2, particularly when she has active lesions in the birth canal at the time of delivery, are at risk for contracting herpes. While infection of the fetus or newborn is relatively uncommon, the complications can be serious and may include miscarriage, premature labor, retarded fetal growth, or transmission of the HSV infection to the infant while in the uterus or at the time of delivery.

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The Medifocus Guide on Genital Herpes provides answers to the following important questions and medical issues:

What are the most common symptoms of genital herpes?

Are there any recognized risk factors for developing genital herpes?

What kinds of medical tests are used to establish the diagnosis of genital herpes?

What is the current standard of care for the treatment of genital herpes?

What treatment options are available for the management of genital herpes?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in genital herpes?

Where are the leading hospitals and centers of research for genital herpes?

What are the most important questions to ask my doctor about genital herpes?

What Your Doctor Reads:

Testing for type-specific antibody to herpes simplex virus--implications for clinical practice.

Journal of Antimicrobial Chemotherapy. 2000

Herpes simplex virus: the importance of asymptomatic shedding.

Journal of Antimicrobial Chemotherapy. 2000

Herpes simplex type 2 infections--an update.

Disease-A-Month. 2000

Valaciclovir: a review of its long term utility in the management of genital herpes simplex virus and cytomegalovirus infections.

Drugs. 2000

Impact of antivirals and emergence of drug resistance: HSV-2 epidemic control.

AIDS Patient Care & STDS. 2000

Herpes simplex type 2 infections--an update.

Advances in Internal Medicine. 2000

Improving the management of genital herpes.

Hospital Practice (Office Edition). 1999

New therapies and prevention strategies for genital herpes.

Clinical Infectious Diseases. 1999

Identification and treatment of herpes lesions.

Advances in Wound Care. 1999

Viral sexually transmitted infections: current management strategies.

Journal of Clinical Pharmacy & Therapeutics. 1999

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Genital Warts (Condylomata Acuminata)

(NF009)

Introduction

Genital warts, also known as condyloma acuminata or venereal warts, are a form of sexually transmitted disease (STD). Genital warts are caused by the human papillomavirus (HPV) which is spread by direct contact with an infected partner through vaginal, anal, or oral intercourse. These warts develop in the genital areas including the vagina, vulva, cervix, urethra, and anus of infected women, and the penis and anus of infected men.

Some genital HPV infections do not cause visible warts, yet can lead to more serious conditions such as cancer. HPV is now considered to be the primary cause of abnormal cellular changes that lead to cervical cancer. The risk for cervical cancer appears to be highest in women infected with HPV for more than six months.

High-risk HPV are associated with moderate dysplasia and carcinoma in situ. Severe HPV types have also been associated with an increased risk for other cancers, including other genital and lung cancers. Women initially infected by one type of HPV do not develop immunity to other types.

Up to one in 10 Americans has a genital HPV infection. Between 500,000 and one million new cases occur every year. The disease can affect anyone, regardless of age, race or sexual preference.

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The Medifocus Guide on Genital Warts provides answers to the following important questions and medical issues:

What are the most common symptoms of genital warts?

Are there any recognized risk factors for developing genital warts?

What kinds of medical tests are used to establish the diagnosis of genital warts?

What is the current standard of care for the treatment of genital warts?

What treatment options are available for the management of genital warts?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in genital warts?

Where are the leading hospitals and centers of research for genital warts?

What are the most important questions to ask my doctor about genital warts?

What Your Doctor Reads:

Imiquimod in clinical practice.

Journal of the American Academy of Dermatology. 2000

Topical imiquimod: a review of its use in genital warts.

Drugs. 1999

The management of difficult anogenital warts.

Sexually Transmitted Infections. 1999

Genital warts and their treatment.

Clinical Infectious Diseases. 1999

Viral sexually transmitted infections: current management strategies.

Journal of Clinical Pharmacy & Therapeutics. 1999

Modeling the impact of treatment options in genital warts: patient-applied versus physician-administered therapies.

Clinical Therapeutics. 1999

Treatment of anogenital warts.

Dermatologic Clinics. 1998

Traditional therapies for the treatment of condylomata acuminata (genital warts).

Australasian Journal of Dermatology. 1998

External genital warts: report of the American Medical Association Consensus Conference. AMA Expert Panel on External Genital Warts.

Clinical Infectious Diseases. 1998

Genital warts: their etiology and treatment.

Nursing Times. 1998

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Group B Streptococcus Infection in Newborns

(NF010)

Introduction

Group B streptococcus (GBS) is a bacteria that is a common cause of infection. Sometimes, however, it is present in certain areas of the body but causes no symptoms or illness. This is referred to as colonization. One out of every five women is colonized with GBS in the gastrointestinal or genitourinary tract.

When a woman who is colonized with GBS is pregnant, the bacteria can be passed on to the infant through aspiration of contaminated amniotic fluid or acquisition of the organism during passage through the birth canal. Infection with GBS may occur in one of several locations in the infant's body.

Pregnancy-associated GBS disease can affect the mother, as well. If the infection spreads upward, it can result in maternal sepsis or even meningitis.

The focus of care in GBS disease has become prevention. The goals of care include detection of at risk pregnancies and intrapartum (during delivery) prophylactic (preventive) treatment with antibiotics.

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The Medifocus Guide on Group B Streptococcus in Newborns provides answers to the following important questions and medical issues:

Are there any recognized risk factors for developing Group B Streptococcus in Newborns?

What kinds of medical tests are used to establish the diagnosis of Group B Streptococcus in Newborns?

What is the current standard of care for the treatment of Group B Streptococcus in Newborns?

What treatment options are available for the management of Group B Streptococcus in Newborns?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in Group B Streptococcus in Newborns?

Where are the leading hospitals and centers of research for Group B Streptococcus in Newborns?

What are the most important questions to ask my doctor about Group B Streptococcus in Newborns?

What Your Doctor Reads:

Intrapartum antibiotics for group B streptococcal colonisation.

Cochrane Database of Systematic Reviews [computer file]. 2000

Antimicrobial prevention of early-onset group B streptococcal sepsis: estimates of risk reduction based on a critical literature review.

Pediatrics. 1999

Risk factors for early-onset group B streptococcal sepsis: estimation of odds ratios by critical literature review.

Pediatrics. 1999

Prevention of perinatal group B streptococcal infections.

Pediatric Infectious Disease Journal. 1999

Group B streptococcus.

Lancet. 1999

Prevention of neonatal group B streptococcal infections. Is there a rational prevention strategy?.

Clinics in Perinatology. 1998

Group B streptococcal infections.

Seminars in Perinatology. 1998

Prevention of neonatal group B streptococcal infection.

American Family Physician. 1998

Concepts and controversies in the management of group B streptococcus during pregnancy.

Birth. 1998

Prophylaxis for neonatal group B streptococcus infections.

Seminars in Perinatology. 1998

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Hepatitis B

(NF023)

Introduction

Hepatitis is inflammation of the liver most commonly caused by any of a group of viruses, but which may also be caused by toxic substances, such as drugs, chemicals, alcohol and environmental toxins. Hepatitis infections vary from short-term to chronic, mild to life threatening.

The virus for hepatitis B, formerly called serum hepatitis, is found in semen, blood and saliva. It is spread by contaminated needles, sexual contact, and to children of infected women during childbirth.

About 350 million persons carry the hepatitis B virus (HBV) worldwide. In the United States, there are about 128,000 new cases every year and about 1-1.35 million persons with chronic hepatitis B.

The goals of care for acute hepatitis are relief of symptoms, monitoring for complications and more serious disease, and supportive care through its resolution. The goals of care for all forms of chronic hepatitis are to relieve symptoms, prevent the development of cirrhosis, reduce levels of the virus in the body, and improve survival.

Because there is no cure for hepatitis B, prevention is very important. Some medications are used to inhibit the replication of the HBV DNA, although their effect on the long-term outcome of the illness is as yet uncertain.

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The Medifocus Guide on Hepatitis B provides answers to the following important questions and medical issues:

What are the most common symptoms of Hepatitis B?

Are there any recognized risk factors for developing Hepatitis B?

What kinds of medical tests are used to establish the diagnosis of Hepatitis B?

What is the current standard of care for the treatment of Hepatitis B?

What treatment options are available for the management of Hepatitis B?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in Hepatitis B?

Where are the leading hospitals and centers of research for Hepatitis B?

What are the most important questions to ask my doctor about Hepatitis B?

What Your Doctor Reads:

Hepatitis B: the only vaccine-preventable bloodborne pathogen.

Medicine & Health, Rhode Island. 2000

Hepatitis B virus: infected or just carrying?.

Indian Journal of Gastroenterology. 2000

Risk and management of blood-borne infections in health care workers.

Clinical Microbiology Reviews. 2000

What did we learn from the Shanghai hepatitis A epidemic?.

Journal of Viral Hepatitis. 2000

Antiviral chemotherapy for the treatment of hepatitis B virus infections.

Gastroenterology. 2000

Lamivudine for hepatitis B in clinical practice.

Journal of Medical Virology. 2000

Lamivudine for treating active hepatitis B in renal transplant recipients: a case report.

Clinical Nephrology. 2000

Vaccines for preventing hepatitis B in health-care workers.

Cochrane Database of Systematic Reviews [computer file]. 2000

Intrahepatic T cells in hepatitis B: viral control versus liver cell injury.

Journal of Experimental Medicine. 2000

Current update of pediatric hepatitis vaccine use.

Pediatric Clinics of North America. 2000

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Hepatitis C

(NF022)

Introduction

Hepatitis is inflammation of the liver most commonly caused by any of a group of viruses, but which may also be caused by toxic substances, such as drugs, chemicals, alcohol and environmental toxins.

Hepatitis C virus (HCV) affects about 28,000 people every year and as many as 3.9 million Americans are chronic carriers of the virus. It is estimated that 20% or more of persons with chronic hepatitis C develop cirrhosis, a process that takes 10-20 years.

HCV has the unique ability to cause persistent infection and 70-80% of infected persons become chronic carriers, although most have relatively mild disease with slow progression. The long-term outcome varies significantly for persons with HCV and there is currently no way to determine who will recover or who will develop chronic disease.

Treatment Hepatitis C usually consists of medications, but liver transplant may be appropriate in some cases.

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The Medifocus Guide on Hepatitis C provides answers to the following important questions and medical issues:

What are the most common symptoms of Hepatitis C?

Are there any recognized risk factors for developing Hepatitis C?

What kinds of medical tests are used to establish the diagnosis of Hepatitis C?

What is the current standard of care for the treatment of Hepatitis C?

What treatment options are available for the management of Hepatitis C?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in Hepatitis C?

Where are the leading hospitals and centers of research for Hepatitis C?

What are the most important questions to ask my doctor about Hepatitis C?

What Your Doctor Reads:

Hepatitis C infection: opportunity for exposure in many settings.

Medicine & Health, Rhode Island. 2000

Renal disease associated with hepatitis C infection after kidney and liver transplantation.

Transplantation. 2000

Appropriateness of liver biopsy.

Canadian Journal of Gastroenterology. 2000

Risk and management of blood-borne infections in health care workers.

Clinical Microbiology Reviews. 2000

Hepatitis C: the silent epidemic.

Harvard Mens Health Watch. 2000

Immunogenetics of hepatitis C virus.

Journal of Viral Hepatitis. 2000

Transplantation in the patient with hepatitis C.

Journal of the American Society of Nephrology. 2000

Liver biopsy in Irish hepatitis C-infected patients with inherited bleeding disorders.

British Journal of Haematology. 2000

Hepatitis C, interferon alfa, and depression.

Hepatology. 2000

Who's afraid of hepatitis C?.

American Journal of Nursing. 2000

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Lyme Disease

(NF012)

Introduction

Lyme disease has become the most common tick-borne disease in the US. It was named in 1975 after a number of children presented with symptoms of arthritis in the area of Lyme, Connecticut. It is a bacterial infection that may be associated with potentially serious rheumatological, neurological and cardiological manifestations. Lyme disease primarily affects the skin, heart, joints, and nervous system. There are places in North America where 60% of the ticks are carrying Borellia burgdorferi bacteria, which causes Lyme disease.

Lyme Disease is treated primarily with antibiotics. Surgery may become necessary in rare cases of severe and persistent arthritis of the knee or other joints. A pacemaker may be required temporarily in the event of some heart rhythm abnormalities.

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The Medifocus Guide on Lyme Disease provides answers to the following important questions and medical issues:

What are the most common symptoms of Lyme Disease?

Are there any recognized risk factors for developing Lyme Disease?

What kinds of medical tests are used to establish the diagnosis of Lyme Disease?

What is the current standard of care for the treatment of Lyme Disease?

What treatment options are available for the management of Lyme Disease?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in Lyme Disease?

Where are the leading hospitals and centers of research for Lyme Disease?

What are the most important questions to ask my doctor about Lyme Disease?

What Your Doctor Reads:

Keeping Lyme disease at bay. An integrated approach to prevention.

American Journal of Nursing. 2000

Lyme disease 2000. Emerging zoonoses complicate patient work-up and treatment.

Geriatrics. 2000

AAP issues recommendations on the prevention and treatment of Lyme disease.

American Family Physician. 2000

Lyme borreliosis.

Seminars in Cutaneous Medicine & Surgery. 2000

Pediatric immunization for the future. Lyme disease vaccine and beyond.

Pediatric Clinics of North America. 2000

The Lyme disease vaccine: conception, development, and implementation.

Annals of Internal Medicine. 2000

American Academy of Pediatrics. Committee on Infecious Diseases. Prevention of Lyme disease.

Pediatrics. 2000

Lyme disease.

Pediatric Infectious Disease Journal. 1999

Lyme disease.

Current Opinion in Rheumatology. 1999

Management of Lyme arthritis.

Comprehensive Therapy. 1999

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Shingles

(NF019)

Introduction

Herpes zoster (commonly called "shingles") results from reactivation of the varicella-zoster virus (VZV) acquired during a primary varicella infection (chickenpox). Primary VZV infection occurs when a susceptible individual (usually a child) is exposed to airborne virus via a respiratory route. Over 90% of adults in the United States have evidence of prior VZV infection on blood testing.

While zoster can erupt on almost any part of the body, the most common areas are the face and the torso. The characteristic rash of herpes zoster is often preceded by a prodrome of burning pain, itching or sensitivity of the affected area.

The skin lesions begin as a red, raised rash that follows a dermatomal distribution. The rash evolves into small fluid-filled blisters (vesicles) on a reddened base. The vesicles are generally painful, and their development is often associated with the occurrence of flu-like symptoms and anxiety. The vesicles eventually become cloudy and may bleed. Within 7-10 days, the vesicles crust over. As these crusts fall off, scarring and changes in skin color may remain.

While medications do not cure zoster infections, they have been found to help shorten the duration and discomfort of the outbreak. Perhaps more importantly, antiviral medications have been found to help reduce or prevent the occurrence of postherpetic neuralgia pain.

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The Medifocus Guide on Shingles provides answers to the following important questions and medical issues:

What are the most common symptoms of shingles?

Are there any recognized risk factors for developing shingles?

What kinds of medical tests are used to establish the diagnosis of shingles?

What is the current standard of care for the treatment of shingles?

What treatment options are available for the management of shingles?

Are there any promising new developments or potential breakthroughs in treatment?

Who are the most notable medical authorities who specialize in shingles?

Where are the leading hospitals and centers of research for shingles?

What are the most important questions to ask my doctor about shingles?

What Your Doctor Reads:

Zoster paresis of the shoulder. Case report and review of the literature.

Clinical Orthopaedics & Related Research. 2000

The role of sympathetic nerve blocks in herpes zoster and postherpetic neuralgia.

Pain. 2000

Acute and chronic herpes zoster. An ancient scourge yields to timely therapy.

Postgraduate Medicine. 2000

Valaciclovir: a review of its use in the management of herpes zoster.

Drugs. 2000

Varicella-Zoster virus: pathogenesis, immunity, and clinical management in hematopoietic cell transplant recipients.

Biology of Blood & Marrow Transplantation. 2000

Prospects for the prevention of postherpetic neuralgia in herpes zoster patients.

Clinical Journal of Pain. 2000

Treatment of postherpetic neuralgia: an update.

Drugs. 2000

Management of herpes zoster (shingles) and postherpetic neuralgia.

American Family Physician. 2000

Does treatment of acute herpes zoster prevent or shorten postherpetic neuralgia?.

Journal of Family Practice. 2000

Neurologic complications of the reactivation of varicella-zoster virus.

New England Journal of Medicine. 2000

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