¿Puedes tener herpes zóster con una prueba de sangre negativa?

Infecciones
1

I am hoping I can get some thoughts on my condition.  I was quite stressed about a month ago.  About 13 days ago I woke up and had numbness on the right side of my face from the back of my cheek bone to the mid-point of my face.  Thinking it was dental related I went to my dentist and he said my teeth are fine.  The symptoms proceeded to get worse.  In addition to numbness I started to feel warm/burning sensation on my cheek and the occastional feeling of pain.  I have not had an injury to my face.  The more disturbing symptoms started about 10 or 11 days ago when I started to have significant flu like symptoms (exhaustion, overall terrible feeling).  I have also had an impact to the taste buds on the right side of my tongue and have experienced more sweating.  But, I have no rash on my face.

Went to my primary care physician on day 7.  He examined me and said I have all the signs of Shingles but no rash.  He said that he would have a BLOOD TEST done to confirm that I had shingles.  The blood test came back negative for shingles so he won't prescribe the antiviral medication because I don't have a rash.  He made a referal to get an MRI and to see a neurologist because he thinks the facial issue and symptoms are not Shingles related.

Based on the reading I have been doing on this site it seems that my symptoms are very classic for the version of shingles that does not come with a rash.  Also, given that I have only been experiencing any symptoms for 13 days I may still develop a rash.

Questions:

Is the Shingles BLOOD TEST reliable?  Since blood was taken on day 8 does the test give false negatives?  In addition, I had shingles about 18 years ago when i was 29 so can this impact the current test? 

2

Richard,

The only blood test for shingles measures the IgG & IgM of the Varicella virus. These are Immunoglobulin G, which measures a past infection, and M, which measures an acute infection. Your G should have been positive, as you have had shingles and chickenpox in the past. The M antibody was measured too early in your disease. The timing has to be perfect to reflect the disease course and the antibody test is not that sensitive a test. The best course of action for your physician would have been to treat you as if you had Herpes Zoster-Shingles. Was the sensation/pain in the same area as before?

Are you immunocompromised?

How old are you? Are you in significant pain?

I am a Nurse Practitioner in the US and have Herpes Zoster-Shingles every three to five weeks for the past twenty years in my right ear and twice in my right eye.

Please let me know how I can help you.

I am sorry for your suffering.

Merry Juliana

3

Hi Merry,

Thank you for your reply.  I really appreciate it.  My prior shingles outbreak was on my lower back when I was 29.  It was a very mild case with virtually no symptoms.  I got a rash and asked my doctor about it because it looked odd.  I did not know anything about shingles at the time.  He told me it was shingles and attributed it to the stress I was feeling from our child coming.

I was not and am not immune compromised.  No current health conditions that I am aware of.  Similiar to the outbreak when I was 29 I think the current outbreak is stress related but the systemic symptoms are much worse.

I am currently 47.

Now that I am 13 days from first symptoms is it worth pushing for an antiviral medication or is it too late to do any measurable good?  

My worst days were last week.  The symptoms that were/are the worst were/are the flu like symptoms.  My face felt/feels funny but the warm/burning sensation on my face was/is very mild and the sensation of pain on my face only happened on day 7.

I am starting to feel a little better.  No where close to 100% but not like I felt on days 5 through 8.

 

4

Hi Richard,

The antivirals stop the virus from replicating, and need to be started within the first 72 hours of the onset of the symptoms or ahem...rash. As your symptoms are improving, and you are experiencing a mild case, there is no need at this point to start the antivirals.

You should be tested in about three weeks from the last IgM & IgG test for Herpes Zoster-Shingles. Even then, the antibody test is not that sensitive, meaning there are many false negatives.

Many physicians are abysmally ignorant regarding Herpes Zoster-Shingles, including diagnosis, treatment, testing, pain management, risk factors, etc. I would consider finding another physician who is interested in treating the person with the symptoms, rather than relying on an inaccurate blood test taken too early in the course of the disease. I would prefer a physician or clinician who is interested in looking up the latest information on Herpes Zoster-Shingles, rather than outdated information he learned many years ago.

Best regards

Merry Juliana

5

Merry,

Thank you for the reply.  I seem to be feeling a little better each day.   The flu like symptoms seem to be getting better.  I do have a question for you about symptoms. I have two that puzzle me and am curious if they occur with shingles.  One is an impact to the taste buds on the right side of my tongue.  As a reminder, my shingles symptoms are on the right side of my face.  Is it common/possible to have an impact within the right side of your mouth from shingles on the same side of your face?

Second, starting on day 8 I noticed that my feet were sweating very badly.  The degree of sweating has deminished from day 8 to today (day 14) but my feet are sweating more than normal.  Is this also a symptom of shingles?

I really appreciate the time you take to post on this site.  You are an incredibly valuable resource to the many people that encounter this health issue.  Thank you!!!

Richard

6

Hi Richard

The tongue is innervated by the Trigeminal V, Spinal Accessory XI, and Hypoglossal XII CRANIAL NERVES.

Yes Herpes Zoster-Shingles can definitely cause numbness and lack of taste of the tongue.

It can also cause the feet sweating as the virus has attacked your central nervous system.

I need to send this, but wish to know how you are doing in a week or sooner if you have any problems.

Best regards

Merry Juliana

7

Hi Merry,

Thanks for your response.  It really helps to understand what is happeing within me.

First an update.  Yesterday and today (day 14 and 15) have been pretty good.  I worked from home and was productive both days. The flu like symptoms have diminished greatly as compared to last week.

I have experienced one new symptom today and am curious if you can help me understand.  As you can read above my shingles is on the right side of my face.  The sensation for the past two weeks has been from the back of my cheek to the mid point of my face with sensation also within my mouth (numbness and impact of taste buds on right side of tongue).  This morning I woke up and started to have a strange sensation within my right ear.  It is an occasional pulsing sensation.  The sensation is not painful, just very distracting.  The pulsing was intermittent early in the day and has increased in frequency as the day has gone on.  I have also felt more run down as the day has gone on so I don't know if that has a correlation. You state above that you get Shingles in your ear.  How would you describe the feeling/sensation you get in your ear?

Also, do you recomend any level of excercise while recovering from Shingles?

Thank you so much for being a resource.  I can't express how much gratitude I have for you taking the time to respond to my questions.

Richard

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¿Tienes alguna actualización en los últimos 5 días desde que publicaste esto por primera vez? Mis herpes zóster faciales comenzaron con un parpadeo en el ojo y finalmente la erupción, lo que lo hizo obvio y ni siquiera creo que me hice un análisis de sangre. No sé mucho sobre el herpes zóster sin erupción, pero ¿cómo ha progresado? He oído que es poco probable que lo contraigas dos veces, pero me gustaría saber cualquier información al respecto también.

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Hi, Merry.  Even though this thread was a year ago, I read your response to Richard's questions with great interest.  I feel horrible for you, suffering through so many bouts of shingles.  Are you still active on this site?  If so, I'd love to run a few questions by you myself, as I'm finding it very difficult to get answers anywhere.  Thanks!

Lynn

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Hi Lynn,

I am very active on this site... I have learned to deal with Herpes Zoster-Shingles and other illnesses...I am resilient, to say the least....

Please let me know what is going on with you....I always love updates!

Best Regards... again

Merry Juliana

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Hola Merry

soy Christine en Nueva Zelanda

Me siento un poco como Lynn.

mi cerebro aún está confuso, después de casi tres años.

Mi equilibrio aún no es muy bueno y mi memoria es terrible.

Desde la última vez que hablé contigo, he tenido cáncer en la vejiga, que está en curso, con 6 tratamientos semanales. He tenido una erupción horrible en las manos desde antes de que se diagnosticara el cáncer. No puedo tocar ninguna maleza o hierba fuera sin que comience el picor.

Mi cerebro está tan cansado tratando de entenderlo todo.

mi dermatólogo dijo que las toxinas en mi vejiga o riñones podrían estar causando la erupción. ¿Crees que es posible?

La única vez que me siento bien es cuando estoy quieta y no caminando. Creo que he envejecido 10 años en los últimos 12 meses.

Es encantador verte en línea ayudando a tantas personas

Espero que estés lidiando con tus propios problemas y no hayas tenido más contratiempos.

Abrazos Christine

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My Dearest Christine,

I am so sorry you have bladder cancer! Are you being treated with BCG? I am assuming they did an MRI, Ultrasound, and biopsies, and found no invasion of the muscle wall?

The bladder cancer may explain why you developed Herpes Zoster-Shingles. While I had/have autoimmune diseases going on for decades, the Herpes Zoster-Shingles was recurrent every 2-1/2 to 3 weeks. I was diagnosed with breast cancer (with my identical twin sister at the same time, same tumor type, markers, size, breast, location, everything...)

Fortunately, the prognosis is excellent for both of us. Once the cancer was removed via partial mastectomy, the frequency of episodes decreased. I also attribute that to a High Lysine low Arginine diet.

I became extremely allergic and itchy to a lot of substances and medications (13 or 14 meds.)

I am still on "mild" chemo, and still an allergic, itchy, itchy girl, BTW.

You get chemo brain or fog, where everything is hazy and dull, and you can't remember facts.

My balance is off from the two strokes that affected the cerebellum and cerebrum, and the Herpes Zoster-Shingles that affects my inner ear.

I do not know what medications they are using for the bladder cancer, and if they are instilling it via the bladder. Hopefully, yours is a low grade tumor.

Cancer and chemo certainly alters your immunity so that itchy rashes are not unusual.

Has your dermatologist prescribed excellent ointments and pills to take? If not, let me know, as I am knowledgeable about itching and what works.

Avoid warm, hot water. Cold and ice soothes itching. Oatmeal creams and baths can be very soothing.

I cannot remember where your original Herpes Zoster-Shingles Rash was and your age.

Again, I am so sorry for this news. You are such a sweet person.

Best Wishes

Merry Juliana

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Hola Merry

Me alegra mucho haberte escrito.

Sí, estoy en el segundo curso de 6 semanas en BCG. El primer tumor era malo y este segundo no es tan malo.

Creo que después de esta ronda pasaré a revisiones cada 3 meses, pero no estoy segura. Me hice una resonancia magnética en los riñones, pero no en otras partes. Empezaba a preocuparme, pero después de leer tu carta me siento mucho mejor al respecto.

Tuve culebrilla en la cara y el hombro, síndrome de Ramsay Hunt

y parálisis.

Gracias por tu información, la valoro mucho.

Debemos mantener el contacto. Realmente has pasado por mucho y eres increíble la forma en que lo has manejado.

Abrazos, Christine xx

14

Lo siento, olvidé las pastillas para el picor, la primera era de fuerza infantil 1% de cortisona y prednisona durante 5 meses, acabo de dejarlo. Mi médico me acaba de dar un ungüento para el picor. Es bastante fuerte y mi piel es muy fina.

Mañana enviaré el nombre, no lo tengo conmigo,

la tableta está fallando.

abrazos xxx

15

Christine,

The one medication that helped me more than any ointment was Doxepin. It is a poor antidepressant, but is the best anti-itch medication known. As you had Ramsay Hunt Syndrome, your balance is going to be way off, unfortunately. I still fall quite easily and can never right myself. My semicircular canal is dehisced or ruptured.

Best Wishes

Merry Juliana

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Muchas gracias Merry, veré si el médico me lo receta.

La pomada que me dio es Aristocort "Triamcinolona" 2% de cortisona. Solo puedo usarla hasta tres veces al día, pero no con ningún otro humectante. Mis manos están tan secas y agrietadas y necesito usarla.

Gracias por toda tu ayuda

Cuídate

Christine xxx

El BCG se pone directamente en la vejiga, tengo que quedarme allí

durante dos horas. Tarda aproximadamente 7 horas antes de que el escozor desaparezca

Hasta donde yo sé no ha atravesado la pared de la vejiga

Ninguno de mis médicos ha relacionado el problema de equilibrio con el Ramsay Hunt, hace que uno se pregunte....y no les gusta cuando miras en el computador Lol

El primer tumor fue malo, este no tan malo, pero ambos en el mismo lugar.

17

Lo siento, fue confuso, no podía mover la página hacia arriba

tableta tonta, necesito una nueva computadora xxxx

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Christine,

I always know I am getting Ramsay Hunt as I start becoming off balance, before the pain, headaches, etc. I also get orthostatic changes such as lightheaded when I go from lying to sitting to Standing.

Best Wishes

Merry Juliana

19

Christine,

My hands are really bad, as well. I only use Baby Magic Wash on my skin to wash my face, hands, and bathe, or Liquid Dove for Sensitive Skin.