Can someone tell me if this sounds like shingles in the mouth please?!!

Infections
1

Hi everyone,

About 4 weeks ago I started to feel very tired/exhausted. I was under a lot of stress also. Around the same time my tongue and way back of my Throat started to burn and then the burn intensified over the next couple of weeks. Also I continued to feel very tired and developed a low grade fever. About a little over a week ago (2.5 to 3 weeks in with this burning tongue) I developed a bunch of blisters type ulcers in a line on the side of my tongue. Only on the right side of the tongue. At around that tome when the blister/sore got very big, I was put on Valtrex 1000mg 3x/day   

I had shingles under my armpit 5 years ago on the same side. Does this sound like shingles to you all??? I'm in my 4th week of this. Please someone let me know. 

Also is burning pain on tongue and in mouth associated with shingles of the mouth?? 

Please provide insight. Thank you!!!

2

Dear Amy,

I am so sorry you are going through this.

Yes, this certainly sounds like shingles. The burning, containment to one side, and accompanying symptoms of fever and fatigue are classic for shingles. I am glad to hear that you were started on Valtrex. Do you also have a severe headache?

I am a Nurse Practitioner in the States and have had Herpes Zoster Shingles in my right ear every three to five weeks for the past twenty-one years. I get the vesicles-blisters in my right ear, as well as the right side of my mouth. I understand exactly what you are going through.

Avoid warm or hot foods and liquids. Cold and iced fluids are beneficial for the pain and swelling!

Did you get an analgesic for the pain?

If you have any more questions, please feel free to ask.

Best Wishes

Merry Juliana

3

Thank you so much Merry!!! May God bless you for your kindness to us all. 

May I please ask some more questions?

So I had malaise/low grade fever and overall not feeling well at the onset of the burning of my tongue. 

That lasted 3 to 3.5 weeks before I looked in the mirror and saw the big sore with blisters across one side of my tongue. Does that still seem like it would fit shingles presentation? 

Also the sore lesion/rash is fading , but I still have the burning pain on my tongue? Some times it goes away for hours, then it's back the next day. I'm about 4.5 weeks into it at this point.

Does this still sound like shingles in the mouth?

I was only able to get on anti-virals about 1.5 weeks ago because NO ONE knew what it was and the lesion/rash had not presented at that time.

Did I catch it in time or will

I have to deal with post herpatic neuralgia?

Please provide an insight! Thank you for your reponse before. Also is there anything I can do to help with the horrible tongue burning pain?

Thank you so much!

4

Amy,

Let me think ie research of an oral rinse to use...

I will message you back in a while

Merry Juliana

5

Amy,

Sorry for the late reply

Here is a recipe for

MAGIC MOUTHWASH

PRESCRIPTION

1 Part 2%Viscous Xylocaine

1 Part Diphenhydramine

(12.5mg/5ml)

1 Part Solucortef

Swish, Hold, and Spit

The longer you hold it over the blisters, the longer the effect. The xylocaine will help numb the pain, but is dangerous if swallowed, as it lessens the gag and cough reflex.

The Diphenhydramine and Solucortef will help reduce the pain and inflammation.

You also might ask your physician for a tapering dose of prednisone to make sure help with the mouth ulcers/burning.

Unfortunately, the magic mouthwash requires a prescription. You absolutely cannot swallow it due to the xylocaine numbing your protective reflexes...

I hope this helps you.

Merry Juliana

6

Amy,

Let me think ie research of an oral rinse to use...

I will message you back in a while

Merry Juliana

7

BTW, Amy, the antivirals still work, even if they are not prescribed within the 3 day time frame.

The original studies were done within three days of onset of the rash, and that is the reason for the use of three days.

Merry Juliana

8

Thank you so so much!!!

 Also I had no idea that antivirals would still work! That is great information!!

If shingles is in the mouth, what dermatome seems to be affected?

So again using your expertise, do you still believe this is most likely shingles and I'm going the right treatment route?

Thank you!

9

Amy,

It is Cranial Nerve V, the Trigeminal Nerve, Mandibular Branch that has been affected.

The unilateral burning pain of the tongue and mouth is the exact dermatome and sensation that Shingles would cause of the Trigeminal Nerve, Mandibular Branch.

The accompanying symptoms of fever and fatigue classic for shingles.

Merry Juliana

10

Merry, 

Thank you again for such kindness you are showing in answering these questions. I hope that you are feeling well. Are you outbreak free currently? I really hope you are. 

I only have a couple more questions for you (unless I remember something else, but I don't think so). Please, can you answer these last questions?

1). Why did my rash/lesions come so late? About 2.5 weeks after the burning pain, malaise and fever). 

2). My pain is mostly unilaterally but at some times of the day it can be all over my tongue or on my hard palate for instance? Can the pain be referred at times with shingles--to other locations even though it primarily affects unilaterally?

3). Occasionally also my teeth will be sore with this outbreak? Have you ever heard of that?

4). I have had this for 4.5 weeks the rash/lesions for about 2 now. How long does it take for shingles to resolve.?

5). Do you think I will have post herpatic pain? 

6). I was prescribed Gabapentin a couple days ago. Should I take it? I have been leery of taking it. 

Is there any other supplements you would take to speed healing? (E.g.  L-lysine, etc). I'm going to try the magic mouthwash! 

Cold drinks have been helping too. Great recommendations from you! 

Please answer these 6 last questions that I have. I know I have taken up your time. But I cannot tell you how much I appreciate your help in this. 

Thank you again Merry!!!

Amy

11

Hi Merry,

Not sure if you got my last email post? Hope I didn't ask you too many questions

Amy

12

Hi Amy, we are so blessed to have Merry on this forum! She's an Angel! I have just had a very similar episode to yours - actually went to the dentist for tooth ache, he found nothing wrong even with X-rays. I also had two painful white lesions on my tongue on that left side. It resolved after a few days. Then I had a rash. A week later I had electric pain on the other side when brushing my teeth, burning on my tongue and palate, malaise and tiredness. Started coughing and the doctor said the red lesions on my throat and palate were Strep throat! I'm also taking Valacyclovir, a strong antibiotic and Lycine. It's not fun, hope you feel better soon! 

13

Amy,

I have been having medical tests done MRIs. etc all day..I am replying to Emails now

Merry Juliana

14

Hi Amy,

Sorry it took so long to get back to you. I wasn't trying to ignore you...I needed some medical tests today and have been responding to my family's and neighbor's needs.

1. Shingles does not read the text books. With my first episode of Herpes Zoster-Shingles, it took 3-1/2 weeks for the rash to appear in my ear canal. Of course I had severe, lancinating pain where I felt there was a cattle prod stuck in my ear into the middle of my brain while trying to give birth through my ear canal.

2. Pain can cross the midline, especially in areas so we'll innervated as the tongue and mouth.

3.Pain can be referred with Shingles, and set your teeth off.

If the pain persists in a tooth, see your dentist ASAP!

4. The duration of shingles is individualized. That being said, the classic case should last one month, but that rarely happens. Most people have compromised immune systems, which can prolong the Shingles and can cause complications.

My first episode lasted about 4 months.

5. I have no way of predicting whether anyone will have Post Herpetic Neuralgia PHN.

The people who do tend to get PHN are those whose pain is not well controlled within the first month. The physicians who refuse Opioids are adding to the problem, as Opioids are still the best analgesic to control acute severe Shingles pain.

6.I would consider trying Gabapentin for the benefit of avoiding PHN, as studies have shown that those taking Gabapentin have less risk of development of PHN.

Just do not drive, care for small children, etc, as you may be drowsy when taking the Gabapentin. It also takes a couple weeks to start working and needs to be tapered up to be beneficial.

(I am on another anticonvulsant, Topiramate, which helps me during Shingles, and I am certain has prevented PHN in me. )

7. Regarding supplements:

I have never been a big fan of supplements for people who eat a nutritious diet, as what your body doesn't need, it excretes out. I eat a nutritious diet with fruit and vegetables. When I had a second stroke, my hem/onc. did a vitamin/mineral survey as well as many other studies to see what was causing the strokes.

My vitamin levels were super high, just eating a nutritious Mediterranean diet, not even a multivitamin.

I would Google the High Lysine, Low Arginine Herpes Diet.

My episodes of Shingles and the intensity of pain have plummeted since I adopted this diet. ( I must give credit to "Shoe Lady" on this forum. I was oblivious to this connection and am indebted to her for helping with my quality of life. )

Supplements are often not pure, and when taken in excess, can do more harm than good. The best way to get Lysine is through the food. It is the ratio of Lysine to Arginine that matters.

(I admit to taking a Centrum Multivitamin now as I am at hi risk for Macular Degeneration and need the Lutein. Otherwise, I wouldn't bother. I get my calcium through my milk consumption.)

I do take Vitamin D3 as I have a very low Vitamin D level-16.

I hope this helps you.

Best Wishes

Merry Juliana

15

Thank you so very much for that kind and informative email Merry! That helped me so much!! Great idea about the herpes diet!!! I will definitely start it!!

I'm going to make an appt with my dentist tomorrow because my tooth is still bothering me. Just from your experience, what can happen with teeth and shingles? I know you said in your email make an appt ASAP. 

(I'm sorry I said I wouldn't ask any more questions! I truly think the above is the last question!) 

Thank you so much again Merry!

Amy

16

Thank you for replying! We sure did have similar cases!!! Wow! So what do you have strep Throat or shingles or both?  Are you taking antivirals the same times as antibiotics?

Amy

17

Hi Amy,

I am unaware of actual damage to teeth by the Herpes Zoster-Shingles virus. The problem with any viral infection is a secondary bacterial infection, and I certainly had a severe bacterial Otitis Media with my Shingles in my right ear. That is why you need to see the dentist as the virus makes the tissue more susceptible to bacterial infections.

Amy,

It is ok to ask questions...

I am very happy to help you and others.

Let me know how you do.

Best Wishes

Merry Juliana

18

Hi Amy, the PA said the Strep throat was probably due to having Shingles - my husband didn't get the Strep. I took antibiotics for the Strep and Valacyclovir. Ten days later the cough flared up and I lost my voice, so I was given a "Z-pack" - I'm feeling extremely tired the last few days with no energy, had sharp face pain when I washed my face tonight. I'm taking 1 gram Valacyclovir twice a day again. This has been the worst bout I've had, almost a month! The rash is completely gone now. This forum is wonderful. Hope you're better and hope our Merry is doing better too  💐

19

Hi Merry! 

I hope you are doing well. I haven't written in a little bit because I was feeling better. Now the last few days I have felt burning again and pain in my tongue/mouth and noticed a little blister right where the last rash/lesion was. In the same exact spot!!

Could this be a reoccurrence in only like a week and half of the rash clearing up? Or did the rash just not completely die off and this is just the last of it?  I have never heard that you could have back to back shingles within a week and half of each other. This is so strange and discouraging. I thought I was getting better. 

If this can be a reoccurrence after just having it a week and half ago on my tongue do I start Valtrex again? I'm so confused. 

Please provide an knowledge. I would so appreciate it again!

Thank you,

Amy 

20

I'm so sorry to hear that you aren't feeling good. Wow, strep with the shingles and then a cough!! That is horrible. 

Did the Dr. say why the strep would be caused by the shingles? Also for my knowledge because I'm thinking I might be having a reoccurrence, why did you decide to start the Valtrex again?