Herpes zoster virus lesion of the pharynx: causes, symptoms, diagnosis, treatment

Herpes zoster of the pharynx is caused by the chickenpox virus, which affects the sensory nerves (usually intercostal and trigeminal) and the skin in the area where their nerve endings exit. The disease is characterized by an acute rash along individual sensory nerves of pink spots with fuzzy borders of significant size (from 3 cm and more), against the background of which by the end of the 1st or on the 2nd day, groups of closely packed blisters the size of a millet grain or small lentils filled with transparent liquid are formed.

Viral lesions of the pharynx are caused by the activation of its latent form for one reason or another, as a result of which the virus migrates along the nerve fibers of the second branch of the trigeminal nerve to its nerve endings and, penetrating into the submucosal layer, causes corresponding pathomorphological changes in it and in the mucous membrane.

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Pathogenesis of herpes zoster of the pharynx

Vegetating in the nerve ganglia of almost all healthy people, the herpes zoster virus "waits in the wings" to manifest itself as an acute infectious disease with a very distressing oral-pharyngeal syndrome of herpes zoster of the pharynx. Factors that contribute to the activation of the virus are general and local cooling, common colds, adenovirus infection, wounds at a distance and in the oral cavity, the presence of poorly installed dentures, general infections, syphilis, malaria, meningitis, etc. Drug intoxications (arsenic, bismuth, iodine, mercury, etc.) also contribute to the activation of the dormant virus. A number of researchers believe that the virus initially penetrates the skin and through it along the nerve trunks reaches the spinal nerve nodes and the spinal cord and from there along the corresponding nerves spreads to certain zones, causing specific pathomorphological changes in them. By releasing exotoxin, the herpes zoster virus causes the development of a general toxic syndrome, the main point of application of which is the nervous system. Others believe that the constant place of vegetation of the virus is the pharynx, and only under the influence of a number of pathological circumstances does it enter the blood, from there into the nerve trunks and along them into the skin and mucous membranes of the oral cavity,

Pathological anatomy

Morphologically, the vesicle of herpes zoster is very similar to similar elements of chickenpox and herpes simplex. However, more detailed histological studies have shown that with herpes zoster, lesions of the neurons of the nerve nodes are found, characteristic of radiculomyelitis. Lesions of the mucous membrane in herpes zoster of the pharynx are almost identical to those that occur in other viral-vesicular infections developing in the oral cavity, so that for a long time herpes zoster of the pharynx and herpetic angina were regarded as one disease.

Symptoms of Herpes Zoster of the Pharynx

Unlike herpetic angina, with herpes zoster of the pharynx, pain occurs 1-2 days before the rash and immediately becomes intense and extremely painful, especially in the elderly. Vesicles appear on one side, corresponding to the affected nerve, and very rarely on both sides. They spread, as a rule, along the fibers of the palatine nerve along the soft palate, the upper third of the anterior palatine arch and the vault of the hard palate. The pain that arises can radiate to the nasopharynx, the eye of the same half, the ear, the retromaxillary region, causing pterygopalatine ganglion syndrome on the affected side. The disease lasts 5-15 days, leaving behind persistent whitish scars on the mucous membranes, into which the nerve endings of the "causal" nerves fall, which causes long-term neuralgia of the corresponding branches of the trigeminal nerve.

Diagnosis of herpes zoster of the pharynx

Diagnosis of herpes zoster of the pharynx with a clearly localized picture of the rash and typical general clinical phenomena does not cause difficulties, especially if the bucopharyngeal form is accompanied by a characteristic zone of skin damage. The disease is differentiated from herpetic angina, pemphigus (see below) and oral manifestations of chickenpox.

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Treatment of herpes zoster of the pharynx

Treatment of herpes zoster of the pharynx is the same as for herpetic angina. There are indications of positive results of using auromycin. For neuralgia, radiation therapy, analgesics, and B vitamins are used.