Herpes Simplex Virus Flashcards

1
Q

What type of virus is HSV?

A

Double-stranded DNA virus

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2
Q

What are the two main types of HSV?

A
  • HSV-1
  • HSV-2
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3
Q

What does HSV-1 manifest as?

A

Oral herpes (cold sores)

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4
Q

What does HSV-2 manifest as?

A

Genital herpes

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5
Q

How is HSV transmitted?

A

Direct contact with infected secretions or lesions

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6
Q

What are the clinical features of genital herpes?

A
  • Painful genital ulceration
  • Dysuria (may or may not be present)
  • Itching
  • Primary infection is worse than recurrent episodes
  • More systemic symptoms in primary infection (e.g. headache, fever, malaise)
  • Tender inguinal lymphadenopathy
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7
Q

What investigations are used for genital herpes?

A
  • NAAT
  • HSV serology
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8
Q

What is the general management for genital herpes?

A
  • Saline baths
  • Analgesia
  • Topical anaesthetics (e.g. lidocaine)
  • Oral acyclovir
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9
Q

What is the management for pregnant women with a primary attack of HSV?

A

Elective c-section if primary attack of HSV >28 weeks gestation

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10
Q

What is keratitis?

A

Inflammation of the cornea

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11
Q

What is the most common cause of keratitis?

A

Herpes simplex virus infection

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12
Q

What are the clinical presentations of primary herpes keratitis?

A
  • Mild symptoms
  • Blepharoconjunctivitis
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13
Q

What are the clinical presentations of recurrent herpes keratitis?

A
  • Painful red eye
  • Photophobia
  • Vesicles (fluid-filled blisters)
  • Foreign body sensation
  • Watery discharge
  • Reduced visual acuity
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14
Q

What investigations are used for herpes keratitis?

A
  • Slit lamp examination
  • Fluorescein staining (shows dendritic ulcer)
  • Corneal scrapings
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15
Q

What is the management for herpes keratitis?

A
  • Urgent assessment from ophthalmologist
  • Topical or oral antivirals
  • Corneal transplant
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16
Q

What brain region is herpes encephalitis characteristically associated with?

A

Temporal lobes

17
Q

What is the most common type of HSV causing herpes encephalitis?

18
Q

What are the clinical features of herpes encephalitis?

A
  • Fever
  • Headache
  • Seizures
  • Nausea and vomiting
  • Focal features (e.g. aphasia)
19
Q

What investigations are used for herpes encephalitis?

A
  • CSF (lymphocytosis)
  • PCR (HSV)
  • CT (temporal +/- frontal lobe changes, e.g. petechial haemorrhage)
20
Q

What is the management for herpes encephalitis?

A

IV acyclovir