<aside> 💡 α Herpesvirus reactivation

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Acute first attack - Chickenpox, reactivation: Herpes Zoster / Shingles.

Clinical

• Painful, blistering, itchy rash along dermatome nerve (trigeminal).
• Severe & encephalitis in immunocompromised.

Disease course

• Initial epithelial infection, mild in children, severe in adults.
• Latent phase in sensory neurons of spinal dorsal root ganglia.
• Reactivation & dermatomal spread results in Shingles/HZ (one attack in immunocompetent, but multiple attacks in immunocompromised / elderly so vaccine recommended for elderly.

Diagnosis: PCR / Tzanck smear.