Shingles with no rash?
December 21, 2009 9:32 AM   Subscribe

He thought it was an ear infection. Doc says shingles. Really?

So Mr. BlahLaLa had a cold, followed by an earache that eventually got so strong and annoying he thought it was an ear infection. He also has a lot of pain all over the side of his head -- same side as the ear. So this morning he went to the doc...who said his ear is totally clear, and instead all that pain is because Hubby has is shingles.

But he has no rash.

Doc prescribed heavy-duty Valtrex, but said the pain might take more than a week to subside. Mr. BlahLahLah did have chicken pox as a kid.

You're Not Our Doctor, but here are our questions:

#1: Shingles? Really?
#2: We co-sleep with our 6.5 year old kid. Is this contagious?

If anyone can shed some light on this non-rashy shingles, we would appreciate it. Also, we'd love to hear about the prognosis for this. Hubby tensed up at the doc's and didn't quite absorb everything the doc was saying.
posted by BlahLaLa to Health & Fitness (14 answers total) 1 user marked this as a favorite
IAMAD. But, anecdotally: my grandad had this, and wasn't diagnosed properly the first time, precisely because he didn't have the rash. He has pain on his head for years after that as he didn't get the medication soon enough. So, it can happen with no rash.

I got shingles (with rash) a couple years ago after a long flight, was diagnosed at a medi-centre and have no effect whatsoever. I've always understood that it's a matter of getting the anti-virals really quickly.
posted by Kurichina at 9:44 AM on December 21, 2009

Best answer: I don't know whether it's possible to have shingles without the rash, but when I had it the rash was a tiny cluster of about 5 light spots which would have been very easy to miss if I hadn't been looking for them. It might be worth, um, thoroughly inspecting your husband.
posted by fire&wings at 9:46 AM on December 21, 2009

When I read your question, I thought immediately of Ramsay Hunt Syndrome* which is aka shingles of the middle ear. As I understand it, a rash is not much of an aid to diagnosis, like it is with other types of shingles, because the nerves along which the shingles travel are inside the ear and hence not visible.

As to question #2: Shingles of all sorts can be contagious, transmitting as chicken pox to individuals who haven't already had chicken pox or haven't been vaccinated for it.

*IAAD, but not a medical doctor. I've come across Ramsay Hunt because my twenty-something stepdaughter had it.
posted by DrGail at 9:47 AM on December 21, 2009

Call your physician and ask them about the co-sleeping arrangement and the prognosis. Your kid has had both doses of the varicella vaccine, right?
posted by grouse at 9:54 AM on December 21, 2009

Best answer: I had shingles in October/November. It was horrible. It literally brought me to my knees in pain. It's worth taking the antivirals if it will ease things in the long run (just my opinion, IANAD).

As far as the contagious factor - shingles are contagious to people who have NOT had chicken pox or the Chicken Pox vaccine, though even the vaccine is not 100% effective.

Ugh. Shingles. Not fun.
posted by Abbril at 10:24 AM on December 21, 2009

Best answer: I just went through this (Ramsay Hunt Syndrome) in July. Lasted about six weeks for me, from beginning to end. My doctor said I was no longer contagious once the pustules had crusted over. I continued sleeping in the same bed with my wife throughout, without problem. You and your husband have my sympathies; Ramsay Hunt Syndrome Type II was the worst thing I've ever gone through.
posted by unclejeffy at 11:27 AM on December 21, 2009

Best answer: "You cannot get shingles directly from someone else with shingles. However, if you have not had chickenpox, you can get chickenpox from close contact with open blisters of someone with shingles." From here.

My husband had shingles recently and since I was about to have a baby, we asked a lot of questions about contagiousness. This is pretty much what we heard from many many doctors and nurses.
posted by freezer cake at 12:04 PM on December 21, 2009

Best answer: It is absolutely possible to get shingles without a rash, yes. It's called zoster sine herpete (i.e., "shingles without a rash") and it's generally associated with involvement of the inner ear and/or the trigeminal nerve.
posted by Sidhedevil at 12:35 PM on December 21, 2009

However, if you have not had chickenpox, you can get chickenpox from close contact with open blisters of someone with shingles.

And of course, this can then develop into shingles later on in life.
posted by grouse at 1:24 PM on December 21, 2009

Just an anecdote...I haven't taken Valtrex but I've taken Famvir which is similar. The dosage had me take a whole bunch at once to start, and it made me violently ill for the first day...if it says that vomiting and diarrhea are possible side effects, be warned and don't take too much at once.
posted by radioamy at 2:14 PM on December 21, 2009

FWIW, I got chicken pox as a kid - but I STILL got shingles when I was seven because apparently the case was not "severe" enough. I've had wacky immune issues for most of my adult life. So it's possible.
posted by medea42 at 2:18 PM on December 21, 2009

Response by poster: Thanks, everyone. Lots of best answers.

We did a follow-up call with the doc, and it turns out the second possible diagnosis is trigeminal neuropathy (sp?), so it sounds like Mr. BlahLahLa is in for some pain, unfortunately.
posted by BlahLaLa at 5:35 PM on December 21, 2009

Best answer: medea42 writes "FWIW, I got chicken pox as a kid - but I STILL got shingles when I was seven because apparently the case was not 'severe' enough. I've had wacky immune issues for most of my adult life. So it's possible."

You only get shingles if you've had chicken pox in the past. Chicken pox is the short term result and shingles a later term result:
The initial infection with varicella zoster virus (VZV) causes the acute (short-lived) illness chickenpox, and generally occurs in children and young people. Once an episode of chickenpox has resolved, the virus is not eliminated from the body but can go on to cause shingles—an illness with very different symptoms—often many years after the initial infection.
posted by Mitheral at 7:23 PM on December 21, 2009

Best answer: Ugh, I had shingles in my 20's. The pre-herpatic back pain was intense, with sudden severe onset. Until the rash appeared, the VA doctors were stumped (due to my age...)

I take Acyclovir to help prevent cold sores, and I think it helps to prevent a return of the shingles.

Trigeminal neuropathy is also extremely sucky!! Your poor Mr!

PLEASE keep in mind that long term severe untreatable pain can cause (or exacerbate) depression. So if your Mr has days of the blues, weeks of ennui, after prolonged unrelenting pain, help him to get help for pain-related depression as well.

Best of luck to you both. Don't settle for doctors who say there is NO treatment. Research on your own, and advocate for yourselves. Most doctors are afraid to give pain relief for fear of addiction, because they don't understand the addiction and pain spectrums. Keep notes, and don't be afraid to doctor shop if you think you are not being taken seriously!
posted by Jinx of the 2nd Law at 10:20 PM on December 21, 2009

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