Herpes Simplex Virus (HSV) Overview

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Questions and Answers

What is the most common cause of genital herpes?

HSV-2 (correct)

Varicella-zoster virus

Cytomegalovirus

HSV-1

What is a common manifestation in neonates infected with herpes simplex virus?

Infantile spasms

Chronic lung disease

Pneumonia with respiratory distress (correct)

Congestive heart failure

Which complication is most likely to occur with anal and perianal herpes?

Intracranial calcifications

Hemorrhagic syndrome

Vesicle formation on the face

Bacterial superinfection (correct)

What is the incubation period for the infection?

2-12 days Signup and view all the answers

Which of the following symptoms is NOT commonly associated with early infection?

Fatigue Signup and view all the answers

What is the mortality rate for neonatal herpes simplex virus infection?

65-80% Signup and view all the answers

In which population is gingivostomatitis most commonly seen?

Children or young adults Signup and view all the answers

What systemic manifestations can accompany early infection of genital herpes?

Fever and alteration of the general condition Signup and view all the answers

What is a possible complication of ocular manifestations of herpes simplex infection?

Blindness Signup and view all the answers

Which of the following can occur as a result of primary maternal infection before 28 weeks of gestation?

Spontaneous abortion Signup and view all the answers

What characteristic does the vesicular eruption in genital herpes typically have?

Erythematous base evolving towards ulcerations Signup and view all the answers

Which condition could result from autoinoculation after touching a herpes lesion?

Eczema herpeticum Signup and view all the answers

Which type of herpes virus is primarily responsible for herpetic keratitis?

HSV-1 Signup and view all the answers

What factor increases the risk of transmission of herpes simplex virus during delivery?

Primary infection during late pregnancy Signup and view all the answers

Which symptom is associated with Herpes simplex encephalitis?

Hemorrhagic, necrotizing encephalitis Signup and view all the answers

What is a common trigger for herpes gladiatorum?

Microabrasions in the skin Signup and view all the answers

What is the primary site of infection for Herpes Simplex Virus 1 (HSV-1)?

Oral mucosa Signup and view all the answers

Which population has the highest prevalence of HSV-2 infection?

Prostitutes Signup and view all the answers

Through which method is Herpes Simplex Virus most commonly transmitted?

Direct contact with secretions Signup and view all the answers

What immune response is initially triggered by a Herpes Simplex Virus infection?

IgM antibodies Signup and view all the answers

What is the role of sensory nerve endings in Herpes Simplex Virus infections?

They transport the virus to nerve cell bodies. Signup and view all the answers

What is indicated by the presence of IgM antibodies for HSV-1 and 2 in a serum test?

Primary infection or reactivation Signup and view all the answers

Which condition can result due to the invasion of HSV into the central nervous system?

Herpes simplex encephalitis Signup and view all the answers

When does viremia associated with Herpes Simplex Virus become more intense?

In infants born to infected mothers Signup and view all the answers

Which diagnostic method can confirm the presence of HSV in vesicular lesions?

Polymerase chain reaction (PCR) Signup and view all the answers

In what state does HSV reside after causing an initial infection?

Latent state in sensory ganglia Signup and view all the answers

What change in cerebrospinal fluid (CSF) is most indicative of HSV encephalitis?

Lymphocytic pleocytosis Signup and view all the answers

What is the recommended intravenous dosage of Acyclovir for herpes simplex encephalitis?

3x5 mg/kg/day Signup and view all the answers

What is a characteristic finding in the brain MRI of a patient with HSV encephalitis?

Lesions predominantly in the temporal and frontal lobes Signup and view all the answers

What is the mechanism of action of Acyclovir in treating HSV infections?

Inhibiting viral DNA polymerase Signup and view all the answers

Which of the following treatments is recommended for severe skin and mucosa reactivations of HSV?

5 days of Valaciclovir Signup and view all the answers

What long-term treatment is advised for patients with multiple HSV reactivations per year?

Valaciclovir or Famciclovir chemoprophylaxis Signup and view all the answers

Study Notes

Herpes Simplex Virus (HSV) Infections

HSV-1 and HSV-2 are alpha herpesviruses infecting skin, mucous membranes, and sometimes the central nervous system.
HSV-1 typically affects the head, while HSV-2 affects the genitals. Both can affect orofacial and genital areas.
The majority of adults have antibodies to HSV-1.
HSV-2 infection is less common, but prevalence in some high-risk groups is high (up to 90%).
Humans are the only reservoir for HSV.
Infection can be symptomatic or asymptomatic (subclinical), with viral shedding (saliva, genital secretions).
Transmission occurs through contact with oral secretions, genital fluids, or mucocutaneous lesions, including mother-to-child transmission.

Pathogenesis

Mucosal surfaces or skin are the main entry points for HSV.
Viral replication occurs in the nerve endings, eventually traveling to nerve cell bodies in ganglia.
The virus spreads to other mucosal sites via sensory nerves.
HSV establishes latency in sensory ganglia.
Reactivation occurs due to immunodeficiency.

Clinical Manifestations

Early Infection: May be asymptomatic or involve fever, malaise, myalgia, and skin/mucosal lesions.
Gingivostomatitis/Herpetic Pharyngitis: Often in children/young adults, presenting with fever, malaise, and oropharyngeal lesions (mouth ulcers).
Oro-Labial Herpes (Herpes Labialis): Common recurrent form, characterized by vesicles on the lips.
Herpetic Whitlow: Vesicles on fingers, often in individuals who practice contact sports.
Herpes Gladiatorum: Skin vesicles in individuals who participate in sports with close contact.
Eczema Herpeticum: HSV infection on eczema-prone skin.
Ocular Manifestations: Keratitis, with potential for blindness.
Herpes Simplex Encephalitis: Rare but severe, characterized by lesions often in the temporal and frontal lobes, potentially causing significant neurological damage.

Visceral Herpes Infections

These involve internal organs (e.g., pneumonia, hepatitis, esophagitis).
More common in immunocompromised patients.

Neonatal Herpes

Most commonly caused by HSV-2.
Transmission can occur during delivery through direct contact with maternal fluids or rarely across the placenta.
Severe illness, with potential for encephalitis, pneumonia, keratitis, sepsis, and high mortality/significant neurological sequelae in survivors.

Congenital Herpes

Infrequent and often occurs before the 28th week of pregnancy.
Symptoms can involve birth defects and/or delays (central nervous system, sensory organs) or miscarriage.

Diagnosis

Tzanck smears (giant cells), IgM antibodies (primary infection).
PCR for viral DNA.
CSF analysis (for HSV encephalitis).

Treatment

Acyclovir (oral or intravenous) is the mainstay treatment. Treatment duration depends on severity, and complications.
Topical acyclovir creams may be used for cutaneous/mucosal infections.
Prevention strategies involve avoiding contact with infected individuals, as well as sexual precautions, and pregnancy management if indicated.

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Description

Explore the intricacies of Herpes Simplex Virus (HSV) infections, including HSV-1 and HSV-2, their transmission routes, and pathogenesis. This quiz covers key aspects of how the virus affects the body and the prevalence among different populations.