HSV Flashcards
How is HSV spread usually?
When person sheds virus but lacks symptoms, skin to skin, skin to mucosa, mucosa to skin
What are some risk factors for recurrence of HSV?
Skin/mucosal irritation (UV)
Menstruation
Fever
Common cold
Altered immune states
HIV
Malignancy eg leukaemia
Transplantation
Chemotherapy
Systemic glucocorticoids
Immunosuppressive therapy
Radiotherapy
What are the clinical manifestations of HSV?
May be asymptomatic
May have regional lymphadenopathy
Systemic symptoms (fever, malaise, headaches, myalgia)
Which symptom complex is most common to accompany primary HSV
Primary herpetic gingivostomatitis
Which symptom complex is most common to accompany primary HSV in women?
Primary herpetic vulvovaginitis
What is the laboratory examination for HSV?
Tzanck smear
When is a Tzanck smear positive for HSV?
If acantholytic keratinocytes or multinucleated giant acantholytic keratinocytes are detected
How do you differentiate between HSV antigens and general lesions?
Using antigen detection direct fluorescent antibody. Monoclonal antibodies specific for HSV 1 and 2 antigens detect and differentiate HSV antigens on smear from lesions
What is the diagnosis for HSV?
Viral culture, electron microscopy tests for specimen taken from base of relatively new lesion
What is the treatment for HSV 1?
Treat during prodomal vesicle formation
Topical antiviral eg zovirax cream, apply 5-t day 4-7 days for facial/genital lesions
Oral antivirals eg acyclovir far more effective right and have easier dosing schedule
What is the treatment for HSV 2?
First episode - acyclovir 200mg PO (by mouth)5x a day 10 days
Maintenance - acyclovir 400mg PO bid (by mouth 2 times a day)
Which antivirals may be used instead of acyclovir for HSV 2?
Famcyclovir or valacyclovir
What is gingivostomatitis?
oral infection inside the mouth that can result in mouth sores and ulcers
What is an acantholytic keratinocyte?
Acantholysis is the loss of cohesion between keratinocytes
