Have you ever seen shingles in real life? I for one have not, but I am sure that some of you have witnessed the spread of zoster in parents or older neighbors. On a shadowing shift that I did yesterday in the SCVMC emergency department, a fairly young man (in his 30s) came in with a body rash in the right lower quadrant of his abdomen that started 2 days before. The emergency physician quickly diagnosed the rash as zoster (or herpes zoster), or commonly, shingles caused by reactivation of varicella zoster virus (VZV). The spots were impressive, according to the infectious disease consult called down to the ED. What is even more impressive is that during the time that the patient was waiting in his room (almost 5 hours), more spots began popping up all over his body--his face, neck and chest.
The man presented no other concerning symptoms and was treated with intravenous acyclovir.
What I learned yesterday--keep your eyes open for cool viral infections!