<prompt> Cause of Herpes Zoster ?Primary infection with VZVRecurrent infection with VZVReactivation of latent infection of VZVMultiple infection with VZV  <response>: Ans. is c i.e., Reactivation of latent infection of VZV Varicella zoster virus infection Varicella Chicken pox and Herpes zoster are different manifestations of the same virus infection. The virus is therefore called varicella zoster virus VZA Primary infection with VZV causes chicken pox. Reactivation of latent VZV, when immunity has fallen to ineffective levels causes-Herpes zoster The virus remains dormant in sensory ganglion of trigeminal nerve and reaches the eye along one or more branches of the opthalmic division of the 5th nerve Herpes Zoster Shingles Occurs in old age 60 years or above As a consequence of reactivation of latent infection from the dorsal root ganglion. o Unilateral vesicular eruptions within a dermatomal distribution Dermatomes from T3 to L3 and trigeminal nerve especially ophthalmic branch are involved. o Zoster ophthalmicus - due to reactivation in ophthalmic branch of trigeminal gasserian ganglia o Ramsay Hunt Syndrome - due to reactivation in geniculate ganglion of facial nerve. o Complications Post herpetic neuralgia - most debilitating complication Meningeal irritation Transverse myelitis Cutaneous dissemination Patients with hodgkins disease and non hodgkins lymphoma are at greatest risk for progressive hespes zoster. Bacterial superinfection 