Infections: bacterial, viral, fungal, parasitic: disseminated herpes zoster: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Infections: bacterial, viral, fungal, parasitic: disseminated herpes zoster

Sample item

A 45-year-old woman receiving chemotherapy for lymphoma develops painful dermatomal vesicles over the chest. Four days later about 60 vesicles appear on the trunk and limbs along with fever and cough. What is the most appropriate treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Intravenous acyclovir

Dissemination of zoster in an immunocompromised host, especially with visceral signs such as pneumonitis, needs intravenous acyclovir. Oral agents are reserved for uncomplicated zoster in a healthy host.

Option by option

  • A. Oral prednisolone alone

    Prednisolone alone would worsen viral replication in an immunosuppressed patient.

  • B. Topical acyclovir cream

    Topical acyclovir does not reach the nerve or the viraemic phase and is ineffective.

  • C. Intravenous acyclovir (correct)

    Correct. Disseminated zoster in an immunocompromised patient is treated with intravenous acyclovir.

  • D. Oral valaciclovir alone

    Oral valaciclovir suits localised zoster in a healthy host and gives inadequate cover when disease is disseminated.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Intravenous acyclovir. Dissemination of zoster in an immunocompromised host, especially with visceral signs such as pneumonitis, needs intravenous acyclovir.

Why is "Oral prednisolone alone" not the answer?

Prednisolone alone would worsen viral replication in an immunosuppressed patient.

Why is "Topical acyclovir cream" not the answer?

Topical acyclovir does not reach the nerve or the viraemic phase and is ineffective.

Why is "Oral valaciclovir alone" not the answer?

Oral valaciclovir suits localised zoster in a healthy host and gives inadequate cover when disease is disseminated.

What concept does this question test?

It tests Infections: bacterial, viral, fungal, parasitic: disseminated herpes zoster in Dermatology. Oral agents are reserved for uncomplicated zoster in a healthy host.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infections: bacterial, viral, fungal, parasitic: disseminated herpes zoster?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.