1. Provide basic information about the patient (sex, age, and other general details such as lifestyle habits) and provide an account of their story before and after diagnosis.
The patient is a 9-year-old girl. She has no pre-existing medical conditions, and her physical development is normal. She is 146 cm tall and weighs 42 kg. She loves sports and is an active child. One week before visiting the hospital, she became aware of dullness and dull pain in his shoulders and arms. She was into swimming and practiced so hard every day that she thought her symptoms came from physical exhaustion. After a few days, eczema appeared on the right upper half of the body. She visited the hospital on the morning of her visit because her symptoms worsened.
She has no fever and no symptoms other than a rash. When the doctor asked if she had a history of chickenpox, the patient's mother said she had chickenpox when she was one year old. On her examination, she had a rash characteristic of herpes zoster containing blisters, and upon palpation, she complained of mild pain. At the time of examination, her rash was already in the late stages, and no further spread of the rash was expected.
2. Describe how they identified a problem and the diagnostic tests that were run.
The chickenpox virus often remains in human nerves, and reactivates when fatigue or stress weakens our immune system, causing Herpes zoster (T, n.d.). She has a history of chickenpox and also had a rash characteristic of shingles that she was already in the late stages, so the doctor diagnosed her with shingles after questioning and visual inspection. However, sometimes, a pathological examination of a blood test or a specimen taken from the affected area might need to identify the virus and distinguish it from herpes simplex, which causes symptoms similar to shingles (T, n.d.).
3. List the treatment options for a patient with the same disorder.
The most basic treatment is the oral administration of aciclovir ointment and famciclovir to fight the herpes virus. But if the symptoms are severe, treatment with an intravenous drip of an antiviral drug such as acyclovir or vidarabine is also available (Kunitomi et al., 1989). It is used in patients with immunodeficiency due to immunosuppressants or with rashes on the face that may affect the eye or auditory nerves. Initial treatment is important to prevent postherpetic neuralgia from remaining, but if postherpetic neuralgia remains, anticonvulsants and numbing agents are used for treatment (T, n.d.).In rare cases, patients experience excruciating neuralgia that affects their lives. In that case, treatment methods include local nerve blocks, continuous administration of antidepressants, anticonvulsant herbal medicines, and narcotics (Pathak, 2021).
4.. Provide the treatment option the patient selected and the result of that treatment.
The doctor prescribed acyclovir ointment, famciclovir (an antiviral drug), and CALONAL tablets (an acetaminophen oral pain reliever) to her, and she followed the medication regimen. All her rashes crusted over in 1-2 weeks and her symptoms subsided. However, a large rash on the part of her back persisted, and symptoms characteristic of postherpetic neuralgia persisted for several years. Currently, ten years after her onset, her neuralgia has disappeared.
5. What are your thoughts about the case study and outcome?
This is my own case and based on my actual experience, and also, my father got shingles last month. These backgrounds helped me to tackle this assignment. Shingles rashes are extremely painful and can lead to various serious complications. Again, shingles are very painful. There are vaccines that prevent the onset of herpes zoster, the varicella vaccine and the varicella-zoster vaccine, so I strongly recommend everyone to get these vaccinations (T, n.d.). However, these contain live virus, so "people with weakened immune systems should abstain from the vaccines" (T, n.d., p.3). Also, the textbook states that people over 50 and people with weakened immune systems due to cancer treatment are at high risk for Herpes Zoster (T, n.d.), but I would like to emphasize that young people and even children can also have Herpes Zoster, through this case study.
Thank you for your instruction. (701 words)
References
Kunitomi, T., Akazai, A., Ikeda, M., Oda, M., & Kodani, N. (1989). Comparison of acyclovir and vidarabine in immunocompromised children with varicella-zoster virus infection. Acta paediatrica Japonica : Overseas edition, 31(6), 702–705. Retrieved from https://doi.org/10.1111/j.1442-200x.1989.tb01383.x
Pathak, N. (2021). How to Treat Nerve Pain After Shingles. WebMD. Retrieved from https://www.webmd.com/skin-problems-and-treatments/shingles/understanding-postherpetic-neuralgia-treatment
T. (n.d.). Unit 3: Diseases of the Integumentary & Musculoskeletal Systems.Retrieved from https://my.uopeople.edu/pluginfile.php/1635089/mod_book/chapter/380161/HDUnit03WrittenLecture.pdf
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