PRODROMAL HERPES ZOSTER MIMICKING ODONTALGIA – A DIAGNOSTIC CHALLENGE

Abstract

Herpes zoster (shingles) is caused by reactivation of the latent varicella zoster virus which is present due toan earlier varicella infection (chicken-pox). Herpes Zoster is a less common and endemic disease thanvaricella, although factors causing reactivation are still not well known, but it occurs in older and/orimmunocompromised individuals. Involvement of C3, T5, L1, L2 and first division of trigeminal nerve arethe most frequently encountered whereas the involvement of second and third division of trigeminal nerveis rarely seen. During the prodromal stage, the only presenting symptom may be odontalgia, which mayprove to be a diagnostic challenge for the dentist, since many diseases can cause orofacial pain, and thediagnosis must be properly established before final treatment. Here we present a case of herpes zosterinvolving the second division of trigeminal nerve masquerading as odontalgia. The difficulties in diagnosisand management are discussed.