Herpes Virus Infection Overview

12 Questions

Which human herpes virus is associated with chickenpox during primary infection?

VZV

Which human herpes virus is associated with Kaposisarcoma and lymphomas?

HHV-8

Which age group is most commonly affected by Acute herpetic gingivostomatitis?

6 months - 5 years

Which human herpes virus primarily infects the trigeminal ganglion?

HSV-1

Which human herpes virus is common in children and can cause roseola?

HHV-3

What is the primary causative agent of Acute herpetic gingivostomatitis?

HSV-1

Which oral mucosa types can be affected by herpes simplex virus infection?

Both keratinized and non-keratinized oral mucosa

What are some of the factors that can predispose individuals to oral candidal infection?

Mucosal trauma and poor oral hygiene

Which clinical form of candidiasis is characterized by white cheese plaques that can be scraped off to reveal an erythematous base?

Pseudomembranous candidiasis (thrush)

What is the most common Candida species associated with oral fungal infections?

Candida albicans

In which age groups are individuals more susceptible to oral candidal infections?

Neonates/infants and the elderly

What is a common site for herpes simplex virus infection in the oral cavity?

Vermilion border and adjacent skin

Study Notes

Human Herpes Virus (HHV) Family

HHV-1: Human Simplex Virus-1 (HSV-1) affects the upper half of the body
HHV-2: Human Simplex Virus-2 (HSV-2) affects the lower half of the body
HHV-3: Varicella-Zoster Virus (VZV) causes chickenpox in primary infection and shingles in recurrence
HHV-4: Epstein-Barr Virus (EBV) causes infectious mononucleosis in primary infection and lymphoma in reactivation
HHV-5: Cytomegalovirus (CMV)
HHV-6/7: Roseolovirus, common in children
HHV-8: causes Kaposisarcoma, lymphomas, and Castleman's disease

Primary Infection

Occurs with initial exposure and no prior antibodies, often in young age
Mostly asymptomatic, but can cause acute herpetic gingivostomatitis
Virus travels from sensory nerves to sensory or autonomic ganglia, then to latency
Most common site is the trigeminal ganglion

Acute Herpetic Gingivostomatitis

Causative agent: HSV-1 (90%)
Age range: 6 months to 5 years, peaking at 2-3 years
Symptoms: abrupt onset, cervical lymphadenopathy, chills, fever, nausea, anorexia, irritability, and sore mouth lesions
Lesions progress from pinhead vesicles to small red lesions, then enlarge and develop central ulceration covered by yellow fibrin
Affects keratinized and non-keratinized oral mucosa
Gingiva is enlarged, painful, and erythematous
Resolves in 5-7 days, or 2 weeks in severe cases

Recurrent (Secondary) Infection

Reactivation of the virus, often in older age
Triggered by ultraviolet light, physical or emotional stress, fatigue, heat, cold, pregnancy, allergy, trauma, dental treatment, respiratory illnesses, fever, menstruation, systemic diseases, and malignancy
Affects the epithelium supplied by the sensory ganglion, causing pain, burning, itching, tingling, localized warmth, and erythema
Common site: vermilion border and adjacent skin

Fungal Infection: Candidiasis

Candida species are opportunistic pathogens and part of normal flora (40%), principally C. albicans
Predisposing factors alter the homeostatic mechanisms, leading to infection
Local factors: mucosal trauma, denture, poor hygiene, tobacco, and carbohydrate-rich diet
Extremes of age: neonates/infants and old age
Drugs: broad spectrum antibiotics, steroids, and other immunosuppressant/cytotoxic drugs
Xerostomia: drugs, radiotherapy, Sjögren syndrome
Systemic disease: iron deficiency, iron-deficiency anemia, megaloblastic anemias, acute leukemia, malignant disease, DM, HIV infection and AIDS, and other immunodeficiency states
Three major clinical forms:
- 1. Pseudomembranous candidiasis (thrush)
- 1. Erythematous candidiasis
- 1. Hyperplastic candidiasis (candidal leukoplakia)