M29- HSV Flashcards
what are the 2 types of herpes simplex virus?
type 1 and 2
Describe type 1 herpes simplex virus.
- Type 1 acquired in childhood
- HSV1 is cause of oral lesions
- 70% UK adults have been infected
- Infection through saliva contact
What is primary gingivostomatitis due to HSV1?
- Disease of pre-school children
- Primary infection
- Systemic upset
- Lips, buccal mucosa, hard palate
- Vesicles 1-2mm
- Ulcers
Describe the symptoms of primary gingivostomatitis due to HSV1.
Fever, local lymphadenopathy
How long does primary gingivostomatitis take to recover?
up to 3 weeks to recover
where can primary gingivostomatitis spread?
beyond mouth
what is the treatment of primary gingivostomatitis?
aciclovir treatment
Describe latency.
- Disappears clinically but virologically still virus in trigeminal ganglion
- After primary infection
- Inactive form of virus in sensory nerve cells
- Can reactivate to re-infect mucosal surfaces
What is the cold sore?
- Reactivation from nerves causes active infection
- Various stimuli I.e UV light on skiing trip
what is used to treat cold sores?
Aciclovir therapy or suppression
Are all reactivations symptomatic?
no
Can aciclovir prevent latency?
No
Describe the recurrence of cold sores.
- Multiple cycles of latency and active infection possible
- Natural history is for decreasing frequency
- Only half of infected people get clinical recurrences
- Oral herpetic lesions usually HSV1
- Recurrent intra-oral lesions are rarely HSV
What is an occupational hazard of dentistry?
- Herpetic whitlow
- Use of gloves essential in prevention
What is a lab confirmation of HSV?
Swab of lesion in virus transport medium:
-detection of viral DNA by PCR
what is an example of when herpes affects the brain?
-Herpes simplex encephalitis
virus inflames and kills off nerve cells
What are symptoms of herpes simplex encephalitis?
abnormal mental state,chanhe in mental state and fever
what is herpangina?
Vesicles/ulcers on soft palate
Enteroviruses
including coxsackie viruses (not HSV)
What is the patient age range for herpangina?
Similar patient age range to 1ry HSV gingivostomatitis
how is herpangina diagnosed?
Diagnosis clinically or by PCR test of swab in viral transport medium
what island, foot and mouth disease due to?
enteroviruses -inxluding coxsackie viruses (not HSV)
what outbreaks are common for hand, foot and mouth disease?
family outbreaks
Describe aphthous ulcers.
-Non viral, self limiting
-Recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos:
>Confined to mouth
>Absence of systemic disease
>Begin in childhood, tend to abate in 3rd decade
>Each ulcer lasts less than 3 weeks
Give examples of recurrent ulcers associated with systemic disease (non viral).
-Behçet's disease : >Recurrent oral ulcers >Genital ulcers >Uveitis. >involve visceral organs such as the gastrointestinal tract, pulmonary, musculoskeletal, cardiovascular and neurological systems
-Gluten-sensitive enteropathy or inflammatory bowel disease,
>Diarrhoea, weight loss
-Reiter’s disease
>Arthritis
-Drug reactions
-Skin diseases
>lichen planus, pemphigus, or pemphigoid
what is a main symptom of primary syphilis?
Chancre
What is a chancre?
- Painless indurated ulcer at site of entry of bacterium Treponema pallidum
- Most common site is genital, but oral lesions can be the site of entry
What happens if a chancre goes left undiagnosed and untreated?
can progress to secondary and tertiary syphilis
