Peut-on avoir le zona avec un test sanguin négatif ?

Infections
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

8

Avez-vous des mises à jour au cours des 5 derniers jours depuis que vous avez initialement publié cela ? Mes zona faciaux ont commencé par un clignement des yeux et finalement l'éruption cutanée qui les a rendus évidents et je n'ai même pas pensé à faire un test sanguin. Je ne sais pas grand-chose sur le zona sans éruption cutanée, mais comment cela a-t-il progressé ? J'ai entendu dire que l'avoir deux fois était peu probable, mais je serais curieux de connaître toute information à ce sujet également.

9

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

10

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

11

Bonjour Merry

C'est Christine en Nouvelle-Zélande

Je me sens un peu comme Lynn.

Mon cerveau est encore embrumé, après près de trois ans.

Mon équilibre n'est toujours pas très bon et ma mémoire est terrible.

Depuis la dernière fois que je vous ai parlé, j'ai eu un cancer de la vessie qui est en cours, avec 6 traitements hebdomadaires. J'ai eu une terrible éruption cutanée sur les mains depuis avant que le cancer ne soit diagnostiqué. Je ne peux pas toucher les mauvaises herbes ou l'herbe à l'extérieur sans que les démangeaisons ne commencent.

Mon cerveau est si fatigué d'essayer de comprendre tout cela.

Mon dermatologue a dit que les toxines dans ma vessie ou mes reins pourraient causer l'éruption cutanée. Pensez-vous que cela est possible ?

Le seul moment où je me sens bien, c'est quand je suis immobile et que je ne marche pas. Je pense avoir vieilli de 10 ans au cours des 12 derniers mois.

C'est agréable de vous voir en ligne aider tant de personnes

J'espère que vous gérez vos propres problèmes et n'avez pas eu d'autres bouleversements.

Câlins Christine

12

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

13

Bonjour Merry

Je suis si heureuse de t'avoir écrit.

Oui, je suis en BCG #160; le deuxième cours de six semaines. La première tumeur était une #160; mauvaise et celle-ci n'est pas aussi grave.

Je pense que je serai sous contrôle tous les trois mois après ce tour, mais je ne suis pas sûre. J'ai eu une IRM sur mes reins, mais nulle part ailleurs. Je commençais à m'inquiéter, mais après avoir lu ta lettre, je me sens beaucoup mieux à ce sujet.

J'ai eu le zona sur mon visage et mon épaule, #160; Ramsay Hunt

et une paralysie.

Merci beaucoup pour tes informations, je les apprécie vraiment

Nous devons rester en contact. Tu as vraiment traversé l'épreuve et tu es incroyable de la façon dont tu as géré.

Bisous Christine xx

14

Désolé, j'ai oublié les médicaments contre les démangeaisons, le premier était une crème pour bébé à 1% de cortisone et de prednisone pendant 5 mois, je viens juste d'arrêter. Mon médecin vient de me donner une pommade pour les démangeaisons. Elle est assez forte et ma peau est très fine.

Je vous enverrai le nom demain, je ne l'ai pas avec moi,

l'ordinateur tablette est en panne.

des bisous 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

16

Merci beaucoup Merry, je vais voir si le médecin va me le prescrire.

La pommade qu'il m'a donnée est Aristocort « Triamcinolone » 2% de cortisone. Je ne peux l'utiliser que jusqu'à trois fois par jour, mais pas avec une autre crème hydratante. Mes mains sont si sèches et fissurées et j'ai besoin de l'utiliser.

Merci pour toute votre aide

Prenez soin de vous

Christine xxx

Le BCG est mis directement dans la vessie, je dois rester là

pendant deux heures. Il faut environ 7 heures avant que les picotements ne disparaissent

À ma connaissance, il n'a pas traversé la paroi de la vessie

Aucun de mes médecins n'a lié le problème d'équilibre à la maladie de Ramsay Hunt, ça fait réfléchir.... et ils n'aiment pas ça quand vous regardez sur l'ordinateur Lol

La première tumeur était grave, celle-ci moins grave, mais toutes les deux au même endroit.

17

Désolé, c'était décousu, je n'arrivais pas à faire défiler la page vers le haut

tablette stupide, j'ai besoin d'un nouvel ordinateur xxxx

18

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.