Herpes Simplex Virus Flashcards
What type of virus is HSV?
Double-stranded DNA virus
What are the two main types of HSV?
- HSV-1
- HSV-2
What does HSV-1 manifest as?
Oral herpes (cold sores)
What does HSV-2 manifest as?
Genital herpes
How is HSV transmitted?
Direct contact with infected secretions or lesions
What are the clinical features of genital herpes?
- 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
What investigations are used for genital herpes?
- NAAT
- HSV serology
What is the general management for genital herpes?
- Saline baths
- Analgesia
- Topical anaesthetics (e.g. lidocaine)
- Oral acyclovir
What is the management for pregnant women with a primary attack of HSV?
Elective c-section if primary attack of HSV >28 weeks gestation
What is keratitis?
Inflammation of the cornea
What is the most common cause of keratitis?
Herpes simplex virus infection
What are the clinical presentations of primary herpes keratitis?
- Mild symptoms
- Blepharoconjunctivitis
What are the clinical presentations of recurrent herpes keratitis?
- Painful red eye
- Photophobia
- Vesicles (fluid-filled blisters)
- Foreign body sensation
- Watery discharge
- Reduced visual acuity
What investigations are used for herpes keratitis?
- Slit lamp examination
- Fluorescein staining (shows dendritic ulcer)
- Corneal scrapings
What is the management for herpes keratitis?
- Urgent assessment from ophthalmologist
- Topical or oral antivirals
- Corneal transplant
What brain region is herpes encephalitis characteristically associated with?
Temporal lobes
What is the most common type of HSV causing herpes encephalitis?
HSV-1
What are the clinical features of herpes encephalitis?
- Fever
- Headache
- Seizures
- Nausea and vomiting
- Focal features (e.g. aphasia)
What investigations are used for herpes encephalitis?
- CSF (lymphocytosis)
- PCR (HSV)
- CT (temporal +/- frontal lobe changes, e.g. petechial haemorrhage)
What is the management for herpes encephalitis?
IV acyclovir