herpes simplex virus 1 or 2. Flashcards
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Genital herpes is most often caused by :
HSV 2
Cold sores are usually caused by ?
HSV1
HSV1 presentation
a severe gingivostomatitis
cold sores
HSV2 presentation
painful genital ulceration
may be associated with dysuria and pruritus
primary infection is often more severe than recurrent episodes
systemic features such as headache, fever and malaise are more common in primary episodes
tender inguinal lymphadenopathy
urinary retention may occur
MX OF HERPES HSV1
Management
gingivostomatitis: oral aciclovir, chlorhexidine mouthwash
cold sores: topical aciclovir although the evidence base for this is modest
genital herpes: oral aciclovir.
Some patients with frequent exacerbations may benefit from longer term aciclovir
How to manage genital herpes in pregnancy
elective caesarean at term if a primary hsv2 occurs greater than 28 weeks gestation
Diagnosis of HSV2
NAAT
HSV serology
Management of HSV2
saline bathing
analgesia
topical anaesthetic agents e.g. lidocaine
Reoccurrences - term aciclovir
Skin manifestation of HSV1 and 2
Eczema herpeticum
rapidly progressing painful rash.
monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1–3 mm in diameter
multiple coalescing, crusted vesicles on an erythematous oedematous . There are clusters of vesicles on his wrists = toxic epidermal necrolysis
Eczema herpeticum usually occurs in ?
Children
Predisposing to atopic eczema
Other than HSV what else can cause Eczema herpeticum
Coxsackie virus
Patients with HSV derived Eczema herpeticum should be given?
IV acyclovir
Patients with coxackie virus derived Eczema herpeticum should be given?
DOES NOT RESPOND TO ACYCLOVIR!
