Herpes Simplex Virus

Question 1

What is herpes simplex virus (HSV).

Answer 1

A double stranded DNA virus.

Question 2

What does HSV cause.

Answer 2

A wide variety of syndromes.

Question 3

How is HSV transmitted. (2)

Answer 3

Via infected saliva, genitalia contact.

Question 4

What are the symptoms of HSV. (2)

Answer 4

Cold sores (usually HSV-1). 
Genital herpes (usually HSV-1 and -2).

Question 5

What are the clinical signs of HSV. (4)

Answer 5

Pyrexia.
Herpetic vesicles.
Cervicitis.
Urethritis.

Question 6

What are the manifestations of herpes infections. (9)

Answer 6

Genital herpes. 
Gingivostomatitis. 
Herpetic whitlow. 
Herpes glandiatorum.
Eczema herpeticum. 
Herpes simplex meningitis. 
Systemic infection. 
Herpes simplex encephalitis. 
HSV keratitis.

Question 7

What are the features of genital herpes infection.

Answer 7

Chronic, life-long infection.

Question 8

What is the most common causative organism in genital herpes.

Answer 8

HSV-2.

Question 9

What are the symptoms of genital herpes. (6)

Answer 9

Flu like symptoms. 
Grouped vesicles/papules develop around the genitals, anus or throat. 
These burst, forming shallow ulcers. 
Urethral discharge. 
Dysuria (especially in women). 
Urinary retention.

Question 10

What is the average time for an ulcer to heal in genital herpes.

Answer 10

3 weeks.

Question 11

What is the best prevention of genital herpes.

Answer 11

Condom use, even during oral sex.

Question 12

What are the features of gingivostomatitis.

Answer 12

Ulcers filled with yellow slough appear in the mouth.

Question 13

What are the features of herpetic whitlow.

Answer 13

Abrasions allow the virus the enter the finger, causing a vesicle.

Question 14

What are the features of herpes glandiatorum.

Answer 14

Vesicles form wherever HSV is ground into the skin by force.

Question 15

What are the features of eczema herpeticum.

Answer 15

HSV infection of eczematous skin.

Question 16

Who does eczema herpeticum usually occur in.

Answer 16

Children.

Question 17

How common is herpes simplex meningitis.

Answer 17

Uncommon and usually self limiting.

Question 18

What is the typical causative organism in herpes simplex meningitis.

Answer 18

HSV-2.

Question 19

Who does herpes simplex meningitis usually occur in.

Answer 19

Women during a primary attack.

Question 20

How dangerous is systemic herpes infection.

Answer 20

It is usually mild, but may be life-threatening if immunocompromised.

Question 21

What are the signs of systemic herpes infection. (5)

Answer 21

Fever. 
Sore throat. 
Lymphadenopathy. 
Pneumonitis. 
Hepatitis.

Question 22

What is the pattern of spread in herpes simplex encephalitis.

Answer 22

Spreads from cranial nerve ganglia, to frontal and temporal lobes.

Question 23

When should you suspect herpes simplex encephalitis. (8)

Answer 23

Fever.
Fits. 
Headaches. 
Odd behaviour. 
Dysphasia. 
Hemiparesis. 
Coma. 
Brainstem encephalitis, meningitis or myelitis.

Question 24

What are the features of HSV keratitis.

Answer 24

Corneal dendritic ulcers.

Question 25

What are the causes of recurrent HSV infection. (4)

Answer 25

Dormant HSV in ganglion cells may be reactivated by:
Illness. 
Immunosuppression. 
Menstruation. 
Sunlight.

Question 26

Give an example of a manifestation of dormant HSV infection.

Answer 26

Cold sores.