Presentation
This is almost certainly a much more common disease in underdeveloped communities than is at present appreciated. [ncbi.nlm.nih.gov]
[3], [4] Disseminated disease is the most severe form of neonatal HSV infection. [4], [5] Infants with disseminated disease usually present between 10 and 12 days of life. [5] The clinical presentation is often characterized by sepsis syndrome, with [jcnonweb.com]
HERPETIC WITLOW Herpetic witlow presents as swelling, erythema, vesicles, and ulcerations of the distal fingers. [pedclerk.bsd.uchicago.edu]
More rarely, such presentations are seen in apparently immunocompetent hosts [ 10–12 ]. [academic.oup.com]
Entire Body System
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Malaise
Fever, malaise, headache, and sore throat are presenting features. The vesicles rupture to form ulcerative lesions with grayish exudates on the tonsils and the posterior pharynx. [www1.cgmh.org.tw]
Primary maternal infection may present as a flu-like syndrome with fever, headache, malaise, and myalgias. Many individuals with HSV-2 may never have sores or have only very mild symptoms. [perinatology.com]
Primary infection can present with generalized symptoms of fever and malaise as well. The painful lesions last for 10-14 days and are grouped. Primary infection can also be completely asymptomatic. [clinicaladvisor.com]
About 10 per cent of primary infections cause a more severe form of disease manifested by fever and malaise. [www2.health.vic.gov.au]
May have generalised symptoms of a viral illness (upper respiratory tract infection, mild fever, malaise). May experience photophobia. In immunocompromised individuals and neonates: may become generalised and life-threatening. [patient.info]
Neurologic
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Rabies
HO M, Nash C, Morgan CW, et al: Interferon administration in the cerebro spinal space and its effects on rabies in rabbits. Infect Immun 9:286, 1974. 39. [healio.com]
Some viruses including herpes simplex virus(HSV), varicella-zoster virus (VZV), and rabies may also travel to the CNS along nerves. Viruses are obligate intracellular organisms. [neuropathology-web.org]
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Excitement
Four days before admission, she became pyrexic, extremely excited, and anorexic. One day prior to admission, right-sided convulsions began which slowly progressed to all of the trunk. [healio.com]
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Tonic-Clonic Seizure
The infant was well up to 24 days of age when he was hospitalized at Hospital Guillermo Grant Benavente in Concepcion, Chile with 1-day history of fever, irritability, poor oral intake and generalized tonic-clonic seizures. [nature.com]
Workup
Disseminated Herpes Simplex Virus doi: 10.1097/AOG.0b013e3182841753 In the Trenches In Brief Author Information Authors Article Metrics Metrics The workup for febrile illness in pregnancy can be exhaustive and should include a systematic, stepwise approach [journals.lww.com]
After 10 days of IV ACV therapy, her liver function tests dramatically improved, but her encephalopathy persisted, mandating further workup. [acgcasereports.gi.org]
Other Pathologies
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Gliosis
Pathological findings in the brain: (a) Massive destruction of normal tissue: (b) Focal gliosis: and (c) Calcified inclusion bodies. Paraffin sections, H and E stains, photomicrographs. [healio.com]
Pathologically, HIV encephalitis is characterized by diffuse myelin damage (spongy myelinopathy, gliosis), neuronal loss, vascular damage, microglial nodules, and lymphocytic infiltrates. [neuropathology-web.org]
MRI of the brain performed on day 22 of acyclovir (44 days of age) showed megacystic encephalomalacia with laminar necrosis, gliosis and cortical atrophy with parieto-occipital subdural effusions ( Figure 1a ). [nature.com]
Treatment
This text not only outlines the various disease patterns but gives guidance to rational treatment with antiviral agents. [books.google.com]
It is worth mentioning that they began their treatment on the 20th day of the infant's illness. [healio.com]
Abstract Patients with immunodeficiency or treatment-related immunosuppression are at an increased risk of developing severe herpes simplex virus (HSV) infection. [ncbi.nlm.nih.gov]
In typical presentations, treatment should not be delayed by waiting for laboratory confirmation. Patient-initiated treatment upon first sign of recurrence is effective. [info.gov.hk]
Prognosis
AIDS Pathophysiology AIDS Transmission AIDS Treatment AIDS Prognosis History of AIDS AIDS Stigma [news-medical.net]
Where dissemination occurs, infection carries a grave prognosis. Infection is particularly dangerous in premature infants. In mature infants, infection 10 days or more after birth carries a much improved prognosis. [virology-online.com]
It considers diagnosis and prognosis according to infection category, along with testing modalities and limitations. [cps.ca]
According to the involved organs there are 3 main categories of neonatal HSV, which are characterized by different manifestations and prognosis. (1) HSV localized to the skin, eye and/or mouth, this accounts for 45 % of cases and is generally associated [docksci.com]
Neonatal herpes can result from infection with either HSV-1 or HSV-2; the latter is associated with a poorer prognosis ( 7 ). We report a case of disseminated neonatal herpes infection with HSV-1 and HSV-2. [wwwnc.cdc.gov]
Etiology
Only by specific virologie and serologic laboratory procedures and a high index of suspicion may the viral etiology be proved. [healio.com]
Subsequent magnetic resonance imaging did not show any findings consistent with infarcts, but it did show juxtocortical and periventricular white matter signal abnormality in the parietal lobes, which were of nonspecific etiology. [acgcasereports.gi.org]
Etiology of clinical proctitis among men who have sex with men. Clin Infect Dis. 2004 Jan 15. 38 (2):300-2. [Medline]. Bissessor M, Fairley CK, Read T, Denham I, Bradshaw C, Chen M. [emedicine.medscape.com]
Noninfectious etiologies include cardiac disease and inborn errors of metabolism. [jcnonweb.com]
Infants admitted with pneumonia of uncertain etiology who do not improve after 24 h on antibiotics, especially if the radiographic picture is consistent with viral pneumonia. [cps.ca]
Epidemiology
Varicella Epidemiology and Infectivity Clinical Manifestations Differential Diagnosis from Smallpox Complications Varicella pneumonias Encephalitis Purpura Fulminans. Haemorrhagic Chickenpox Congenital and Neonatal Varicella 7. [elsevier.com]
Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention. Virol J 2009 Occurrence of cytomegalovirus and herpes simplex virus infections in pregnancy. [perinatology.com]
Congenital cytomegalovirus infection: review of the epidemiology and outcome. Obstet Gynecol Surv. 2002; 57 :245–256. [ PubMed ] [ Google Scholar ] 8. Fowler KB, Stagno S, Pass RF. [ncbi.nlm.nih.gov]
Herpes simplex virus type 2: epidemiology and management options in developing countries. Sex Transm Infect. 2007 Feb. 83(1):16-22. [Medline]. [Full Text]. Levett PN. Seroprevalence of HSV-1 and HSV-2 in Barbados. [emedicine.medscape.com]
Epidemiology of herpes simplex virus type 2 in Hong Kong. Hong Kong STD/AIDS Update 1999;5:7-8. Lo JY, Lim WW, Ho DW, Field PR, Cunningham AL. [info.gov.hk]
Pathophysiology
AIDS Pathophysiology AIDS Transmission AIDS Treatment AIDS Prognosis History of AIDS AIDS Stigma [news-medical.net]
Pathophysiology All herpes viruses are enveloped, double-stranded DNA viruses. The DNA sequences of HSV-1 and HSV-2 are very similar, but differences in their envelope proteins allow for serologic distinction between the two. [pedclerk.bsd.uchicago.edu]
Pathophysiology: HSV, belonging to the family Herpesviridae and to the subfamily Alphaherpesvirinae, is a double-stranded DNA virus characterized by the following unique biological properties: Neurovirulence (the capacity to invade and replicate in the [www1.cgmh.org.tw]
The virus interacts with the components and receptors of lipoproteins, which may lead to its development. [28] [29] Pathophysiology Herpes shedding [30] HSV-2 genital 15–25% of days HSV-1 oral 6–33% of days HSV-1 genital 5% of days HSV-2 oral 1% of days [en.wikipedia.org]
Prevention
For these reasons we believe that Poly IC should be given to any suspected or proved case of viral encephalitis, as soon as suspicion is raised in order to prevent irreversible neuronal damage. [healio.com]
Topical antibiotic ointments may be applied to eroded or crusted lesions to prevent secondary infection and accelerate wound healing. [dermquest.com]
Herpes simplex virus infection in pregnancy and in neonate: status of art of epidemiology, diagnosis, therapy and prevention. Virol J 2009 Occurrence of cytomegalovirus and herpes simplex virus infections in pregnancy. [perinatology.com]
This helps prevent an outbreak at the time of delivery. C-section is recommended for pregnant women who have a new herpes sore and are in labor. [medlineplus.gov]