Many patient’s report prodromal symptoms of itching or burning in a dermatome. Pain is in a common symptom. Patient’s may seek medical attention for localized pain of unknown origin. It is not until the rash appears that the source of pain is confirmed. Other symptoms  common to many viral infections may occur. These include fatigue, headache and other flulike symptoms.

Shingles. The patient had severe chest and abdominal pain for several days. X-rays were negative. Abdominal surgery was scheduled. The shingles rash then appeared. That proved that singles was the source of the pain.