Viral Infections Flashcards
Herpes is DNA/RNA virus
DNA
which herpes is oral? which is genital?
1 = oral 2 = genital
what causes primary infection of herpes simple virus?
initial contact with the virus
another name for primary herpes
herpetic gingivostomatitis
how is primary herpes spread?
in saliva usually as a child
what happens to the ulcers in primary herpes?
small ulcers often coalesce, resulting in larger ulcers having serpentine borders
how do you make a dx of primary herpes?
exfoliative cytology or (rarely) biopsy
-infected cells show ballooning or more commonly known as TZANCK CELLS
what is the tx for PRIMARY herpes
acyclovir (if identified in the first 2-3 days)
-valacyclovir is absorbed better than acyclovir and is eventually metabolized to acyclovir
what else can be used to tx PRIMARY HERPES?
topical anesthetics so pt can eat and drink, important to avoid dehydration
-popsickles can be soothing for pediatric pts
what is the px for PRIMARY herpes
generally good
-only one episode that lasts 10-14 days even w/o tx
what are the chances of developing at least one episode of recurrent disease from primary herpes?
25%
what are the two forms of recurrent herpes?
- recurrent herpes labialis
- recurrent intraoral herpes
- only 12% of affected ppl will remember primary infection (subclinical/mild symptoms)
what is RECURRENT herpes labialis also called?
cold sore
fever blister
what is recurrent herpes labialis triggered by?
UV light exposure or trauma
where does recurrent herpes labialis affect?
vermillion zone or perioral skin
with no tx, what happens to the vesicles of recurrent herpes labialis?
vesicles rupture, form a crust, and lesions heal in 7 - 10 days
what is the tx of recurrent herpes labialis?
- avoid sun exposure
- topical antiviral agents
- pt initiated systemic valacyclovir (must be started in first two days of onset)
is recurrent INTRAORAL herpes common?
no
what are the usual symptoms with recurrent intraoral herpes?
irritated or rough feeling, cluster of shallow ulcers
where are recurrent INTRAORAL herpes usually found?
confined to mucosa bound to periosteum (hard palate and attached gingiva) *****
how long does is take recurrent intraoral herpes to heal with NO tx?
one week
what is the major difference for herpes in an immunosuppressed pt?
- ANY oral mucosal surface can be affected
- large shallow ulcers with elevated, scalloped borders
- looks like primary herpes but is actually recurrent
what is the tx for herpes in an immunocompromised pt?
- INTRAVENOUS acyclovir for acute cases
- maintanence therapy with oral acyclovir may be necessary
what is herpetic whitlow?
- one of the hazards associated with not wearing gloves
- despite the host having antibodies to herpesvirus, infection can still be induced with a sufficient viral inoculum