Shingles, the common name for the condition doctors refer to as herpes zoster, results from reactivation of the virus that causes chicken pox within sensory and cranial nerve roots. The Centers for Disease Control and Prevention estimates that 30 percent of Americans develop shingles over the course of a lifetime, with one million new cases reported each year. In addition to pain and a characteristic, one-sided, blistering skin rash, shingles also causes mild flu symptoms in some people.
Clinical Features
Flu symptoms commonly associated with shingles, according to University of Alabama Professor Richard J. Whitley, M.D. in the 2008 edition of "Harrison's Principles of Internal Medicine," include fever, fatigue, head or body aches, poor appetite and a generalized sense of malaise. Fever is typically low-grade or even subjective, where a person feels feverish but body temperature measures normal. People with immune system problems may experience more severe symptoms, including fever up to 103 degrees Fahrenheit, says Whitely. The presence of respiratory symptoms of flu such as dry cough or runny nose suggest that the diagnosis truly is flu.
Time Frame
Flu symptoms related to shingles may begin three to five days before the rash appears, or they may start around the same time. Improvement in flu symptoms parallels healing of lesions. Complete resolution accompanies crusting of skin lesions, within seven to 10 days for people with normal immune systems.
Associated Symptoms
Flu symptoms due to shingles are associated with pain and skin rash. In the 2008 edition of "Fitzpatrick's Dermatology in General Medicine," National Institutes of Health dermatologist Stephen E. Straus, M.D. explains that patients with shingles typically describe severe, deep, boring or piercing pain with an electric quality that localizes to the site of the rash. Skin rash due to shingles, Straus continues, appears as elliptical, 2- to 3-mm blisters confined to the distribution of a single or, in some cases, up to three nerve roots.
Complications
A patient who experience worsening flu symptoms three to five days after the appearance of the skin rash should contact a doctor because this may be a sign of shingles-related complications, such as pneumonia, meningitis, encephalitis or secondary bacterial infections. Pneumonia, says Whitely, represents the most common complication of shingles. Common symptoms, according to the American Lung Association, include cough, chills, chest pain and shortness of breath.
Treatment
Most flu symptoms respond to over-the-counter acetaminophen. The National Institutes of Neurological Disorders and Stroke also recommends prescription antiviral drugs, which reduce the severity and duration of all shingles symptoms, including flu symptoms. Antiviral drugs work best when started within 72 hours of symptoms onset, so the patient should contact a doctor as soon as symptoms appear.
References
- "Harrison's Principles of Internal Medicine, 17th Edition"; A.S. Fauci et al.; 2008
- "Fitzpatrick's Dermatology in General Medicine, 7th Edition"; K. Wolff et al.; 2008
- National Institute of Neurological Disorders and Stroke: Shingles
- Centers for Disease Control and Prevention: Herpes Zoster
- American Lung Association: Pneumonia
