Herpes Simplex Virus Flashcards
1
Q
What is herpes simplex virus?
A
Two strains of HSV in humans → HSV-1 and HSV-2
- 90% of the world’s population over age of 40 carries HSV
2
Q
What causes herpes simplex virus?
A
Transmission → via direct contact with mucosal tissue or secretions of another infected person. Infection with HSV-1 is usually acquired in childhood via saliva. HSV-2 is mostly spread through genital contact.
- HSV-1 ⇒ more commonly causes herpes labialis (cold sores - oral herpes). Also associated with HSV encephalitis.
- HSV-2 → causes genital herpes
3
Q
What are the presenting symptoms of herpes simplex virus?
A
- Genital Ulcer → painful (may be multiple ulcers)
- Dysuria and Pruritus → symptom of genital herpes - Tender Inguinal Lymphadenopathy
- Oral Ulcer (Cold Sores - HSV1)
- Tingling Sensation before appearance of lesion - Erythema Multiforme (target lesions)
- Primary Infection → may present with a severe gingivostomatitis (erythema and painful ulcerations on the perioral skin and oral mucosa)
- Eczema Herpeticum ⇒ severe primary infection of the skin by herpes simplex virus 1 or 2.
- Commonly seen in children with atopic eczema and often presents as a rapidly progressing painful rash.
- Punched out erosions are seen.
- Potentially life-threatening hence children should be admitted for IV aciclovir.
4
Q
What investigations are used to diagnose/ monitor herpes simplex virus?
A
- Viral PCR → order when lesions are present
- Genital Herpes → nucleic acid amplification tests (NAAT) (after obtaining swab of the base of the ulcer)
- Viral Culture
5
Q
How is herpes simplex virus managed?
A
- 1st Line → Oral Acyclovir 400mg three times a day
- Can also be given orally in pregnancy (no different) - Symptomatic Treatment → IV fluids, barrier creams, pain relief, antipyretics, antibiotics
6
Q
What complications may arise following herpes simplex virus?
A
oesophagitis, meningitis, encephalitis, hepatitis, bell’s palsy
