The human herpes virus Flashcards
what are the three main sub families of herpes virus ?
alphaherpes viruses
betaherpes viruses
gamma herpes virus
what is in the the alpha family ?
HSV1
HSV 2
HHV 3 - varicella zoster virus
what is in the beta family ?
HHv5 - cytomegalo virus
human herpes virus 6
human herpes virus 7
what is in the gamma family
HHV4 EBV
HH8 Kaposi sarcoma
what are the types of herpes simplex virus ?
HHV1
HHV2
what is the mode of infection of HSV ?
direct contact
what are the types of infection ?
primary infection
recurrent infection
initial non-primary
what is HSV1 commonly associated with (clinical presentation)?
orolabial herpes
what is HSV2 commonly associated with (clinical presentation)?
genital herpes and usually acquired through sexual contact
what may genital ulcers of HSV2 increase the risk of ?
HIV infections
what are the triggers of a HSV infection ?
- physical and emotional stress
- fever
- exposure to UV light
- tissue damage
- immunosuppression
which ganglia does the HSV-1 rest in ?
trigeminal ganglia
what ganglia does the HSV-2 rest in ?
sacral ganglia
what are the clinical manifestation of HSV disease ?
primary infection - often asymptomatic
reactivation - may be symptomatic is asymptomatic
in what type of patients is reactivation common ?
immunocompromised
what is a subclinical infection ?
asymptomatic viral shedding not being treated
what does the primary lesion look like ?
painful grouped vesicles on an erythmatous base
why do recurrent infections with herpes happen ?
due too the latency of the virus
what are the clinical presentations/manifestations of herpes virus ?
orolabial herpes herpetic whitlow herpes gladitorum erythema multiforme eczema herpeticum keratonconjuctivitis genital herpes neonatal herpes HSV encephalitis
what are the types or orolabial herpes ?
herpetic gingivostomatitis
cold sores
what are the types of genital herpes ?
primary and recurrent ( primary being more severe )
which herpes simplex virus is the most likely causative factor in neonatal herpes ?
HSV-2 , if mother has primary genital infection in the third trimester
what is the clinical spectrum of neonatal herpes ?
- can be localized to the skin, eyes and mouth
- could affect the CNS causing encephalitis with or without skin involvement
- become disseminated and cause encephalitis, hepatitis or pneumonia
what is the laboratory diagnosis for neonatal herpes ?
test vesicle fluid
vesicle swab
CSF for viral nucleic acid
what is the treatment for neonatal herpes?
intravenous acyclovir for 3 weeks
what is the gold standard of diagnosis for HSV encephalitis ?
PCR of CSF
primary or reactivation ? gingivostomatits herpes labials keratonconjuctivitis genital herpes neonatal
primary reactivation primary , reactivation primary, reactivation primary
how is a diagnosis of HSV made ?
mainly clinical PCR serology Skin biopsy Tzanck Smear
what is the prophylaxis of HSV ?
- avoid triggering factors
- awarness
- screening for HSV in pregnant women
- C section with women who have genital herpes
- prophylactic acyclovir in the third trimester
what is the route of admission of acyclovir in neonatal and encephalitis ?
IV
why is valaciclovir used rather than acyclovir?
valaciclovir has a higher drug bioavailability
