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Varizella-zoster-Virusinfektion

Varicella-zoster virus infections

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Zusammenfassung

Die Primärinfektion durch das Varizella-zoster-Virus (VZV) manifestiert sich als Varizellen. Hierbei handelt es sich um eine häufige, hoch kontagiöse Erkrankung vorwiegend des Kindesalters. Das VZV kommt ubiquitär vor und weist eine hohe Prävalenz auf. Das klinische Erscheinungsbild zeigt pleomorphe Effloreszenzen. Eine antivirale Therapie ist nur bei schweren Verläufen, Erwachsenen oder bei immunsupprimierten Patienten erforderlich. Die Varizelleninfektion ist Voraussetzung für die spätere Entwicklung eines Herpes zoster. Der Herpes zoster, ebenfalls durch das Varizella-zoster-Virus hervorgerufen, ist eine neurodermale Krankheit, die als endogenes Rezidiv der Primärinfektion (Varizellen) definiert wird. Klinisch finden sich segmental angeordnete Effloreszenzen in den sensiblen Innervationsgebieten eines Hirn- oder Spinalnerven. Eine der gefürchtetsten Manifestationen des Herpes zoster ist der Schmerz. Zur Behandlung stehen verschiedene antivirale Substanzen zur Verfügung. Eine frühzeitig begonnene Therapie reduziert das Risiko und die Dauer der postherpetischen Neuralgien signifikant. Deshalb sollte die antivirale Therapie in Kombination mit einer adäquaten Schmerztherapie so früh wie möglich begonnen werden.

Abstract

The primary infection with varicella-zoster virus (VZV) is manifest clinically as varicella. It is a common very contagious disease, normally appearing in childhood. VZV is a ubiquitous virus with a high prevalence. Clinically it is characterized by pleomorphic skin lesions. Normally antiviral therapy is necessary only in severe cases, in adults or in immunosuppressed patients. Herpes zoster, also caused by (VZV), is a neurodermal disease representing the endogenous relapse of the primary varicella infection. Herpes zoster is characterized by lesions concentrated in the innervation region of a cranial or spinal nerve. One of the most feared manifestations of herpes zoster is pain. Several antiviral drugs are approved and many studies have shown that antiviral therapy, started early in the course of disease, can significantly reduce risk and duration of postherpetic neuralgia in elderly patients. Therefore, antiviral therapy in combination with an adequate pain management should be given to all elderly patients as soon as herpes zoster is diagnosed.

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Interessenkonflikt: Die korrespondierende Autorin versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

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Lilie, H.M., Wassilew, S.W. Varizella-zoster-Virusinfektion. Hautarzt 55, 831–840 (2004). https://doi.org/10.1007/s00105-004-0789-1

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