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Old 06-11-2011
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Question Herpes Zoster

A 48-year-old man is evaluated because of a painful vesicular rash on the right side of his forehead that began 5 days ago and continues to form new lesions. The patient recently underwent peripheral blood stem cell transplantation for acute myeloblastic leukemia. On physical examination, he is afebrile. Several groups of lesions are present on the right side of his forehead and extend back onto his scalp. None of the lesions is crusted. Ophthalmologic examination is normal. His lungs are clear to auscultation, and neurologic examination is normal.
Which of the following is the most appropriate therapy for this patient?
( A ) Withhold therapy because more than 72 hours have elapsed since the onset of the rash
( B ) Prescribe a 3-day course of oral acyclovir, valacyclovir, or famciclovir
( C ) Prescribe sufficient quantities of topical acyclovir or penciclovir to cover all lesions
( D ) Prescribe sufficient quantities of a topical antibacterial ointment to cover all lesions
( E ) Begin intravenous high-dose acyclovir and institute airborne and contact isolation
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Infectious-Diseases, Step-3-Questions

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