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Primary Herpes Simplex Infection


Presentation

  • A 13-year-old girl presented with postural hypotension, severe abdominal pain and diarrhoea, parotid pain and a transient encephalopathy.[ncbi.nlm.nih.gov]
  • To the Editor: A 33-year-old woman presented with tenderness of the left breast and nipple of 2 weeks’ duration and fever of 2 days’ duration. The pain was so severe it precluded nursing.[mdedge.com]
  • The present study demonstrates that a substantial proportion of pregnant women who are seronegative for HSV-2 are at risk for primary HSV-2 infections because their spouses are infected.[nejm.org]
  • Herpes simplex virus type 2 infections presenting as brainstem encephalitis and recurrent myelitis [in Japanese]. Intern Med 1995 ; 34 : 839 –42. Skoldenberg B , Forsgren M, Alestig K, et al.[jnnp.bmj.com]
Fever
  • In addition, hand-foot-mouth disease (viral etiology) needs to be considered because multiple pinpoint oral vesicles and ulcers, as well as fever, are common signs.[softdental.com]
  • To the Editor: A 33-year-old woman presented with tenderness of the left breast and nipple of 2 weeks’ duration and fever of 2 days’ duration. The pain was so severe it precluded nursing.[mdedge.com]
  • , Fever Blister, Fever Blisters, Sore, Cold, Sores, Cold, herpes labialis, Fever sore, Cold sores lip, Cold sore (herpetic), Herpes on lip, fever blister, herpes febrilis, Herpes Labialis [Disease/Finding], fever sores, lip herpes, herpes lips, herpes[fpnotebook.com]
  • , halitosis Yes 7 Skin lesion, conjunctivitis Maternal: WB Neonate: Cx, WB SEM 10 Alive Yes M 24 C/S 3rd Fever, oral ulcerations, adenopathy No 4 Fever, tachypnea, jaundice, bradycardia Maternal: WB Neonate: FA, Cx, WB Disseminated 11 Died N/A M 25 Vaginal[academic.oup.com]
  • Two weeks post-transplantation, she developed a fever of 37.9 C with no obvious focus of infection and her physical examination was unremarkable.[sjkdt.org]
Malaise
  • The primary episode of herpetic gingivostomatitis is characterized by constitutional symptoms such as malaise, fever and regional lymphadenopathy. Acute ulcerative gingivostomatitis occurs as a result of virus replication in the affected tissues.[softdental.com]
  • 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.[emedicine.medscape.com]
  • 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]
  • The symptoms can be quite severe and may include: blisters and ulceration on external genitalia, in the vagina, or on the cervix vaginal discharge pain and itching tender, enlarged lymph nodes pain when urinating high temperature ( fever ) malaise (feeling[medicalnewstoday.com]
Collapse
  • Bilateral basal lung collapse was noted on chest radiography and intravenous amoxicillin and clavulanic acid were continued post-operatively.[sjkdt.org]
Aphthous Stomatitis
  • The differential diagnosis of primary herpetic gingivostomatitis has been reviewed in the differential diagnosis of recurrent aphthous stomatitis.[softdental.com]
  • RIH may appear similar to traumatic lesions (mechanical/thermal/chemical) or other types of oral mucosal disorders, such as aphthous stomatitis.[jcda.ca]
Skin Ulcer
  • Individuals who participate in contact sports such as wrestling, rugby, and football (soccer), sometimes acquire a condition caused by HSV-1 known as herpes gladiatorum, scrumpox, wrestler's herpes, or mat herpes, which presents as skin ulceration on[en.wikipedia.org]
Vesicular Rash
  • An extensive vesicular rash was noted on the posterior aspect of the right thigh, and bilaterally in the sacral and perianal areas. There were no vesicles elsewhere.[jnnp.bmj.com]
Headache
  • An initial infection starts after an incubation period of 3-7 days, after which fever, headaches, fatigue and muscle pains can occur.[americanskin.org]
  • Symptoms include lymph node enlargement, fever, tiredness, headache, and muscle aches during the episode. Recurrences are preceded by a tingling, itching or burning sensation on the penis one to two days prior to visible blisters and sores.[biology.kenyon.edu]
  • 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.[emedicine.medscape.com]
  • On presentation she was complaining of headache, unsteadiness when walking, double vision, and photophobia. She had no significant previous medical history and, in particular, no history of genital or oral herpes.[jnnp.bmj.com]
  • 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]
Oscillopsia
  • Neurological examination revealed an intention tremor, marked upper limb and truncal ataxia, oscillopsia, and variable ophthalmoplegia with diplopia and multidirectional nystagmus.[jnnp.bmj.com]
Truncal Ataxia
  • Neurological examination revealed an intention tremor, marked upper limb and truncal ataxia, oscillopsia, and variable ophthalmoplegia with diplopia and multidirectional nystagmus.[jnnp.bmj.com]
Nystagmus
  • Neurological examination revealed an intention tremor, marked upper limb and truncal ataxia, oscillopsia, and variable ophthalmoplegia with diplopia and multidirectional nystagmus.[jnnp.bmj.com]

Workup

Herpes Simplex Virus Type 2
  • Double-blind, placebo-controlled trial of a herpes simplex virus type 2 glycoprotein vaccine in persons at high risk for genital herpes infection . J Infect Dis 1990 ;161: 653 –60. 17.[nejm.org]
  • Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med 1997;337: 1105. [ PUBMED ] [ FULLTEXT ] 4. Ichai P, Roque Afonso AM, Sebagh M, et al.[sjkdt.org]
  • Frequency of symptomatic and asymptomatic herpes simplex virus type 2 reactivations among human immunodeficiency virus-infected men. J Infect Dis 1998; 178:1616-22. 9.[hivinsite.ucsf.edu]
  • Infection with the herpes simplex virus, commonly known as herpes, can be due to either herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2).[who.int]
  • simplex virus type 2 glycoprotein G soon after infection.[virologyj.biomedcentral.com]
Viral Inclusion Body
  • General Pathology Corneal scrapings of HSV keratitis prepared with Giemsa stain may reveal the presence of intranuclear viral inclusion bodies. Multinucleated giant cells may also be found.[eyewiki.aao.org]
Liver Biopsy
  • Figure 2A: Liver biopsy H&E. Some hepatocytes around the necrotic areas contain "glassy" nuclei, and there are occasional multinucleate cells. Elsewhere there are scattered apoptotic bodies. Figure 2B. Immunoperoxidase staining for HSV.[sjkdt.org]

Treatment

  • Complete resolution of respiratory symptoms was observed after 21 days of treatment with intravenous aciclovir. Gerhardt syndrome comprises inspiratory dyspnoea without dysphonia.[ncbi.nlm.nih.gov]
  • She was otherwise fit and well and taking no regular drug treatment. She had not travelled outside the United Kingdom in the previous 10 years.[jnnp.bmj.com]
  • Figure 4: Response to treatment in Case 1. Rapid improvement in AST following treatment with IV aciclovir.[sjkdt.org]
  • There is no specific treatment for primary herpetic gingivostomatitis. Acvclovir (Zovirax) is effective in the management of initial herpes genitalis.[softdental.com]
  • Demographic data, data regarding the immune status of the patient, month of infection or re-infection, average temperature during that month, treatment, duration of infection, and type of anterior segment pathology were recorded.[iovs.arvojournals.org]

Prognosis

  • Herpes simplex virus-associated acute liver failure: A difficult diagnosis with a poor prognosis. Liver Transplant 2005;11(12):1550-5. 5. Norvell J, Blei A, Jovanovic BD, et al.[sjkdt.org]
  • 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]
  • Prognosis Prognosis is usually good, but greatly varies depending on severity and number of recurrences of the disease.[eyewiki.aao.org]
  • Prognosis Spontaneous recovery in a few days to a week, occasionally longer. Recurrence is common. The virus remains in the body for life, but it is usually dormant. Research continues in developing a vaccine. Other Nothing Specified.[rxmed.com]
  • It considers diagnosis and prognosis according to infection category, along with testing modalities and limitations.[cps.ca]

Etiology

  • In addition, hand-foot-mouth disease (viral etiology) needs to be considered because multiple pinpoint oral vesicles and ulcers, as well as fever, are common signs.[softdental.com]
  • Herpetic whitlow Pathogen : HSV-1 in 60% of cases; HSV-2 in 40% of cases (in the adult population) Etiology Direct contact with infected secretions through a break in the skin, e.g., torn cuticle Main groups: Children ; (via sucking of thumb/fingers ([amboss.com]
  • Acute respiratory disease of university students with special reference to etiologic role of herpes virus hominis. Am. J. Epidemiol. 101 (1975) 111–121. Google Scholar 2. Katz, J., Mamary, I., Ben-Yehuda, A., Barak, S., Danon, Y.[link.springer.com]
  • Etiology HSV Keratitis is caused by the herpes simplex virus, a double stranded DNA virus made up of an icosahedral shaped capsid surrounding a core of DNA and phosphoproteins of viral chromatin.[eyewiki.aao.org]
  • Ongoing controversies regarding etiology, diagnosis, treatment N/A Copyright 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.[clinicaladvisor.com]

Epidemiology

  • , Hiroshi Kimura , Shinji Kido , Naoki Hanada , Motohiro Shibata , Tsuneo Morishima , Yoichiro Kino Abstract The clinical features and the molecular epidemiology of primary herpes simplex virus type 1 (HSV-1) infection among children younger than 3 years[pediatrics.aappublications.org]
  • Epidemiology Fetal HSV infection much less common than neonatal HSV infection. The estimated incidence is at 1 in 200,000 deliveries 3. Complications Overwhelming fetal sepsis might result in multi-organ failure, including fetal brain death.[radiopaedia.org]
  • 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]
  • Epidemiology of genital herpes in Pittsburgh: serologic, sexual, and racial correlates of apparent and inapparent herpes simplex infections . J Infect Dis 1990 ; 162: 299 –305. 8. Stavraky KM, Rawls WE, Chiavetta J, Donner AP, Wanklin JM. .[nejm.org]
  • 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]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of Gerhardt syndrome remains unexplained, but the possible role of herpes simplex infection should be considered in cases of laryngeal palsy.[ncbi.nlm.nih.gov]
  • General information Pathophysiology Inoculation : The virus enters the body through mucosal surfaces or small dermal lesions. Neurovirulence : The virus invades, spreads, and replicates in nerve cells.[amboss.com]
  • Pathophysiology Add text here Primary prevention Prevention of herpetic infection includes avoidance of direct contact with known HSV.[eyewiki.aao.org]
  • 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]

Prevention

  • To prevent this infection, gloves should be used routinely when examining or treating patients.[softdental.com]
  • It does not clear the virus but prevents the virus from multiplying. It may not have much effect once the blisters and ulcers are well developed.[patient.info]
  • She subsequently made a gradual recovery but was maintained on aciclovir prophylaxis to prevent further episodes of disease.[jnnp.bmj.com]
  • N/A How can HSV-1 infection be prevented? Reducing transmission is an important aspect of prevention. Children with gingivostomatitis should be excluded from child care to prevent transmission to susceptible infants.[clinicaladvisor.com]
  • Centers for Disease Control and Prevention. Genital Herpes - CDC Fact Sheet. Available online at . Page last reviewed September 6, 2012. Accessed January 2013. Centers for Disease Control and Prevention.[labtestsonline.it]

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