Herpes Zoster / Disseminated HSV or VZV in the Immunocompromised

Antimicrobial prescribing: NHS Fife
NHS Fife

Clinical features

  • Vesicular lesions affecting multiple dermatomes

Investigations

  • COPAN swab from de-roofed blister
  • If systemically unwell, consider blood culture
  • Consider HIV testing

Infection Control

  • Isolate with contact precautions
  • Do not place patient in V34 or V44
  • Pregnant staff should avoid caring for the patient

Infectious from 2 days before appearance of rash and until all lesions have crusted

Treatment

ACICLOVIR IV

10mg/kg 8 hourly (use IBW if obese)

For patients showing a good response, consider IVOS to:

ACICLOVIR PO

800mg 5 times per day

Duration: 5 days total OR until 2 days after last new lesions appear, whichever is longer